Provider Demographics
NPI:1023996626
Name:SMITHWICK, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SMITHWICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 HAMBURG STATE PARK RD
Mailing Address - Street 2:
Mailing Address - City:WARTHEN
Mailing Address - State:GA
Mailing Address - Zip Code:31094-3669
Mailing Address - Country:US
Mailing Address - Phone:706-386-9691
Mailing Address - Fax:
Practice Address - Street 1:615 HAMBURG STATE PARK RD
Practice Address - Street 2:
Practice Address - City:WARTHEN
Practice Address - State:GA
Practice Address - Zip Code:31094-3669
Practice Address - Country:US
Practice Address - Phone:706-386-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant