LARRY RAY SMITH MD

Allergy and Immunology

Athens, Georgia

Provider NPI: 1619953569

Provider Information:
 LARRY RAY SMITH MD


Practice Location:
330 HAWTHORNE LN  ATHENS, GA 30606 US
Tel: 706-613-8500  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	207K00000X	Physicians Allergy & Immunology	GA	23506

Other Provider Identifiers:

Issuer	Number	State	Type
	000287328N	GA	05
202I034440	MEDICARE	GA	01
	000287328O	GA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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