Provider Demographics
NPI:1558467472
Name:BYRD-SMITH, JACINDA DENISE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JACINDA
Middle Name:DENISE
Last Name:BYRD-SMITH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:JACINDA
Other - Middle Name:DENISE
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1670 CLAIRMONT ROAD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:404-728-4707
Practice Address - Street 1:1670 CLAIRMONT ROAD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-728-4707
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0192951835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist