Provider Demographics
NPI:1699030106
Name:SMITHSON, COLBY JANE SMITH
Entity Type:Individual
Prefix:MRS
First Name:COLBY
Middle Name:JANE SMITH
Last Name:SMITHSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2595 ASHFORD RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3203
Mailing Address - Country:US
Mailing Address - Phone:478-262-1082
Mailing Address - Fax:
Practice Address - Street 1:3155 N POINT PKWY
Practice Address - Street 2:BUILDING F, SUITE 100
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5481
Practice Address - Country:US
Practice Address - Phone:770-645-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant