Provider Demographics
NPI:1952471278
Name:SMITH, EARL DAVID (DC)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:DAVID
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1091
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-1091
Mailing Address - Country:US
Mailing Address - Phone:706-965-5777
Mailing Address - Fax:706-965-5787
Practice Address - Street 1:29 LEGION ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2369
Practice Address - Country:US
Practice Address - Phone:706-965-5777
Practice Address - Fax:706-965-5787
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6245111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHTGMedicare ID - Type Unspecified
GAU77008Medicare UPIN