Smith, Mallory
Smith, Mallory is an individual health care provider with primary practice located at 125 Memorial Dr , Reidsville GA 30453-4641. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Smith, Mallory can be contacted via phone (912) 557-3434.Contact Information
Primary practice address
125 Memorial Dr
Reidsville GA 30453-4641
Phone: (912) 557-3434
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 022471 | Georgia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 022471 | Georgia |
Profile Details
| NPI number | 1568406437 |
|---|---|
| LBN Legal business name | Smith, Mallory |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Aug 13th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568406437 | NPPES |
| Georgia | MEDICAID | 000251842G |
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