Individual provider · Type 1 NPI

Jacob Baston Smith

Medical Physician Assistant · Carrollton, GA

NPI number 1922945229 Active

Practice location

705 Dixie St
Carrollton, GA 30117-3818

Mailing address

607 Valley Run Dr
Bremen, GA 30110-2413

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1922945229

Jacob Baston Smith's National Provider Identifier is 1922945229, issued on May 4, 2026. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Carrollton, GA. The record was last updated on May 4, 2026.