Doctor Name: | JOHN DARRELL SMITH |
NPI Number: | 1023054806 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036012 |
Business Practice Address: | 11 Upper Riverdale Rd, Sw Riverdale, GA - 302742615 |
Business Phone Number: | 7709918130 |
Business Fax Number: | 7709918630 |
Mailing Address: | 11 Upper Riverdale Rd, Sw, RIVERDALE |
State: | GA |
Postal Code: | 302742615 |
Phone Number: | 7709918130 |
Fax Number: | 7709918630 |
NPI Enumeration Date: | 06/21/2006 |
NPI Last Update Date: | 02/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RC0000X |
License Number: | 036012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Cardiovascular Disease |
Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |