Provider Demographics
NPI:1578689436
Name:SMITH-LAMBERT CLINIC, P.C.
Entity Type:Organization
Organization Name:SMITH-LAMBERT CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:706-846-3151
Mailing Address - Street 1:PO BOX 3188
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:GA
Mailing Address - Zip Code:31816-3188
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3214 ROOSEVELT HWY
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:GA
Practice Address - Zip Code:31816-6418
Practice Address - Country:US
Practice Address - Phone:706-846-3151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00678422BMedicaid
GA00076645BMedicaid
GAG14967Medicare UPIN
GAE00341Medicare UPIN
GA08BDCMXMedicare ID - Type Unspecified
GA08BDKPRMedicare ID - Type Unspecified