Provider Demographics
NPI:1558062877
Name:SMITH, TERRANCE JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:JOSEPH
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 RUSSELL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:ELBERTON
Mailing Address - State:GA
Mailing Address - Zip Code:30635
Mailing Address - Country:US
Mailing Address - Phone:678-428-6869
Mailing Address - Fax:
Practice Address - Street 1:350 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3515
Practice Address - Country:US
Practice Address - Phone:864-327-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program