Provider Demographics
NPI:1033348172
Name:SMITH, LAUREN FINNELL (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:FINNELL
Last Name:SMITH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:NICOLE
Other - Last Name:FINNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5462 WHITTLESEY BLVD
Mailing Address - Street 2:APARTMENT 738
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2185
Mailing Address - Country:US
Mailing Address - Phone:312-613-4018
Mailing Address - Fax:
Practice Address - Street 1:1900 10TH AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3600
Practice Address - Country:US
Practice Address - Phone:312-613-4018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL135000679213E00000X
GAPOD001200213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist