Provider Demographics
NPI:1366862799
Name:SMITH, CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 WATERS AVENUE
Mailing Address - Street 2:GENERAL SURGERY RESIDENCY PROGRAM
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404
Mailing Address - Country:US
Mailing Address - Phone:912-350-8598
Mailing Address - Fax:
Practice Address - Street 1:4700 WATERS AVENUE
Practice Address - Street 2:GENERAL SURGERY RESIDENCY PROGRAM
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404
Practice Address - Country:US
Practice Address - Phone:912-350-8598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01081842A208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty