Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | TN |
NPI | 1578532024 |
---|---|
Provider Name | Dr. R. Kuhen Smith |
First Address | Memphis, TN 38117-4579 |
Second Address | Memphis, TN 38117-4579 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T74437 | (02) | TN |