| Smartmed, Llc | |
|
612 Holcomb Bridge Rd Roswell GA 30076-1583 | |
| (678) 928-7391 | |
| Not Available |
| Full Name | Smartmed, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 612 Holcomb Bridge Rd, Roswell, Georgia |
| Authorized Official Name and Position | Lucas Lathrop (OWNER) |
| Authorized Official Contact | 6122102120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smartmed, Llc 1506 Jones Rd Roswell GA 30075-2726 Ph: (612) 201-2120 | Smartmed, Llc 612 Holcomb Bridge Rd Roswell GA 30076-1583 Ph: (678) 928-7391 |
| NPI Number | 1912643040 |
|---|---|
| Provider Enumeration Date | 05/11/2022 |
| Last Update Date | 09/14/2024 |
| Medicare PECOS PAC ID | 1557744356 |
|---|---|
| Medicare Enrollment ID | O20220811000735 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912643040 | NPI | - | NPPES |
| 1336185016 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lucas M Lathrop |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336185016 PECOS PAC ID: 2567475478 Enrollment ID: I20060719000076 |
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