Provider Demographics
NPI:1437567534
Name:SMITH, JAMES G
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E JOHN ST
Mailing Address - Street 2:SUITE 973
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28106-4201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:301 E JOHN ST
Practice Address - Street 2:SUITE 973
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28106-4201
Practice Address - Country:US
Practice Address - Phone:704-882-4743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-01
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor