Provider Demographics
NPI:1235613829
Name:SMITH, ROBBIN (FIRST ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ROBBIN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:FIRST ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6048 WINDY RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-6622
Mailing Address - Country:US
Mailing Address - Phone:678-772-7999
Mailing Address - Fax:770-609-6929
Practice Address - Street 1:6048 WINDY RIDGE TRL
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-6622
Practice Address - Country:US
Practice Address - Phone:678-772-7999
Practice Address - Fax:770-609-6929
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant