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Kirk L Smick

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NPI Number Detailed Information

Provider Information:

Name: Kirk L Smick
Gender: M
Provider License Number If Given: OPT000737

NPI Information:

NPI: 1023002540
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 11/12/2008

Provider Business Mailing Address:

Address: 1000 CORPORATE CENTER DRIVE STE 100
Morrow, GA 30260
Phone Number: 7709688888
Fax Number: 7709602473

Provider Business Practice Location Address:

Address: 1000 CORPORATE CENTER DRIVE SUITE 100
Morrow, GA 30260
Phone Number: 7709688888
Fax Number: 7709602473

Provider Taxonomy:

Primary: 152W00000X
Secondary (if any):
State: GA

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