Provider Demographics
NPI:1447498142
Name:SMITH, AARON SINCLAIR (DC)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:SINCLAIR
Last Name:SMITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:DR. A.SINCLAIR
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2721 SAINT AUGUSTINE TRL SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6264
Mailing Address - Country:US
Mailing Address - Phone:770-374-7302
Mailing Address - Fax:
Practice Address - Street 1:6148 COVINGTON HWY
Practice Address - Street 2:A
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-8371
Practice Address - Country:US
Practice Address - Phone:770-374-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO06733111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU92732Medicare UPIN