Provider Demographics
NPI:1295096964
Name:SMITH, WALKITRIA ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:WALKITRIA
Middle Name:ALEXANDER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:WALKITRIA
Other - Middle Name:MINNIE
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4840 ROSWELL RD # D350
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2639
Mailing Address - Country:US
Mailing Address - Phone:404-590-4250
Mailing Address - Fax:
Practice Address - Street 1:4840 ROSWELL RD # D350
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2639
Practice Address - Country:US
Practice Address - Phone:404-590-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116024402207Q00000X
GA74598207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine