Individual
DR. JERRY JOSEPH SMAHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2140 RIVERSIDE DR, MACON, GA 31204
(478) 953-0024
(478) 953-0675
Mailing address
4501 RUSSELL PKWY, STE 11, WARNER ROBINS, GA 31088
(478) 953-0024
(478) 953-0675
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
017087
GA
2085R0202X
Diagnostic Radiology Physician
Primary
17087
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000093728K
—
GA
05
—
000093728Z
—
GA
01
—
P00144376
RAILROAD MEDICARE
GA
Enumeration date
12/15/2005
Last updated
05/23/2018
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