Provider Demographics
NPI:1033435664
Name:SMITH OF GEORGIA
Entity Type:Organization
Organization Name:SMITH OF GEORGIA
Other - Org Name:SMITH NORTHVIEW HOSPITALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHAMB
Authorized Official - Middle Name:
Authorized Official - Last Name:PUROHIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-671-2000
Mailing Address - Street 1:PO BOX 10010
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-0010
Mailing Address - Country:US
Mailing Address - Phone:229-671-2000
Mailing Address - Fax:229-671-2010
Practice Address - Street 1:4280 N VALDOSTA RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-6814
Practice Address - Country:US
Practice Address - Phone:229-671-2000
Practice Address - Fax:229-671-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA092602282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital