Provider Demographics
NPI:1922054998
Name:SMISSON, HUGH FRANKLIN III
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:FRANKLIN
Last Name:SMISSON
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HUGH
Other - Middle Name:FRANKLIN
Other - Last Name:SMISSON
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:840 PINE ST STE 880
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-7525
Mailing Address - Country:US
Mailing Address - Phone:478-743-7092
Mailing Address - Fax:478-743-6293
Practice Address - Street 1:840 PINE ST
Practice Address - Street 2:SUITE 880
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2100
Practice Address - Country:US
Practice Address - Phone:478-743-7092
Practice Address - Fax:478-743-6293
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035524174400000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00495338AMedicaid
GA14BDBXVMedicare PIN
GA00495338AMedicaid