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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568406437 NPPES
Georgia MEDICAID 000251842G

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