Individual
JAWAUNA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4343 SHALLOWFORD RD STE B4A, MARIETTA, GA 30062-5003
(770) 992-0002
Mailing address
8208 WESLEY PROVIDENCE PKWY, LITHONIA, GA 30038-6966
(678) 939-9051
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006455
GA
Other
Enumeration date
01/14/2014
Last updated
01/14/2014
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