Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 176773 |
NPI | 1093221541 |
---|---|
Provider Name | Jessica Leigh Smith |
First Address | Franklin, GA 30217-3976 |
Second Address | Franklin, GA 30217-3976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2017 |
Last Update Date | 20/12/2017 |