Look up the most recent NPI and PECOS records

Carolyn Ruth Smallwood

Family Medicine

Allopathic & Osteopathic Physicians

1810 White Cir, Suite 105, Marietta, GA 30066-5835

PECOS Enrollment

This provider is enrolled in PECOS as CAROLYN SMALLWOOD.

Based on the most recent information from CMS, provider Carolyn Ruth Smallwood is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1093079204
Provider Type
Individual
Full Name
Smallwood, Carolyn Ruth
Title
Dr.
Credential
D.O.

Gender
Female
Sole Proprietor
No
Enumeration Date
7/2/2012
Last Updated
1/4/2016

Contact Information

Practice Location

1810 White Cir, Suite 105, Marietta, GA 30066-5835

(678) 797-6820

(770) 424-8787

Mailing Location

1810 White Cir, Suite 105, Marietta, GA 30066-5835

(678) 797-6820

(770) 424-8787

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 74101 Georgia
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License TL4519 Colorado

Carolyn Ruth Smallwood

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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