Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD0000020625 | TN |
N | 207VX0000X | Obstetrician | 20625 | TN |
NPI | 1023032083 |
---|---|
Provider Name | Dr. George Walton Smith |
First Address | Knoxville, TN 37916-1831 |
Second Address | Knoxville, TN 37916-1839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 26/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3054343 | (05) | TN |
D90665 | (02) | TN |