Provider Demographics
NPI:1386648079
Name:SMITH, THOMAS HARDING III (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HARDING
Last Name:SMITH
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 933049
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-3049
Mailing Address - Country:US
Mailing Address - Phone:866-313-5266
Mailing Address - Fax:205-313-5298
Practice Address - Street 1:2260 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4764
Practice Address - Country:US
Practice Address - Phone:866-313-5266
Practice Address - Fax:205-313-5298
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA040793207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ40793Medicaid
SCQ40793Medicaid
G90436Medicare UPIN