Derrick Smith

NPI #1003366840 in Leesburg, Georgia

Provider Information

NPI Number: 1003366840
Entity Type: Individual
Name: Derrick Smith
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Enumeration Date: Oct 5, 2016
Last Updated: Oct 5, 2016

Practice Location

Address: 100 MEDLEY DR
City: Leesburg
State: Georgia
ZIP Code: 31763-3272
Phone: (229) 343-8849

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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