Individual
JUSTIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
304 SHORTER AVE NW STE 201, ROME, GA 30165-4256
(706) 509-3358
(706) 292-7653
Mailing address
304 SHORTER AVE NW STE 201, ROME, GA 30165-4256
(706) 509-3358
(706) 292-7653
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
075250
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
GA
Other
Enumeration date
05/16/2014
Last updated
02/17/2016
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