Individual
MARY BETH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
603 WHEAT AVE STE 450, BAINBRIDGE, GA 39819-4365
(229) 246-1209
(229) 243-7707
Mailing address
603 WHEAT AVE STE 450, BAINBRIDGE, GA 39819-4365
(229) 246-1209
(229) 243-7707
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
LL32829
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136009A
—
GA
01
—
070431
MEDICAL LICENSE
GA
Enumeration date
06/18/2010
Last updated
07/21/2022
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