Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD34792 | TN |
N | 208600000X | Surgeon | MD34792 | TN |
Y | 2086S0120X | Pediatric Surgery | MD34792 | TN |
NPI | 1225022890 |
---|---|
Provider Name | Dr. Lisa A Smith |
First Address | Chattanooga, TN 37403-2136 |
Second Address | Chattanooga, TN 37403-2136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 18/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00893516A | (05) | GA |
009947640 | (05) | AL |
1246480 002 | CIGNA (01) | |
1700058 | UHC (01) | |
2536518 | (05) | OH |
370017967 | RR MEDICARE (01) | |
4001261 | BCBS OF TN (01) | |
62165877467 | JDH (01) | |
7613562 | (05) | NC |
H30906 | (02) | |
Q000856 | (05) | TN |