Kenneth L. Smith PA-C

NPI 1124226568 - Physician Assistant - 363AM0700X

NPI Details
NPI 1124226568
Gender Male
Enumeration Date 07/06/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1120 15TH ST
NEPHROLOGY DIVISION, MEDICAL COLLEGE OF GA, BA-9413
AUGUSTA GA, 30912-0004, US
Phone (706) 721-2861
Fax
Business Location
4208 FAIRFIELD CIR
EVANS GA, 30809-3628, US
Phone (706) 650-9552
Fax
Toxanomy
Taxonomy Code 363AM0700X
License State Georgia
License Number 000725
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According to our database, Mr. Kenneth L. Smith PA-C NPI is 1124226568, taxonomy code is 363AM0700X and license number is 000725, license state is located at Georgia. Kenneth L. Smith PA-C physically located at 1120 15th St, Augusta GA, 30912-0004. NPI Number Kenneth L. Smith PA-C has the Individual type.

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1124226568 NPI number is provided on an as is basis without warranty of any kind. 1124226568 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth L. Smith PA-C are for informational purposes only.