Individual
GREGORY SCOTT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4030 LAWRENCEVILLE HWY NW, STE. 9, LILBURN, GA 30047-3011
(770) 921-4811
(770) 921-7943
Mailing address
PO BOX 769609, ROSWELL, GA 30076-8224
(770) 921-4811
(770) 921-7943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042440
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124308A
—
GA
05
—
003124308B
—
GA
05
—
003124308C
—
GA
01
—
1609816123
GEORGIA CLINIC PC GROUP NPI #
GA
Enumeration date
10/12/2006
Last updated
12/15/2014
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