Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD0000016206 | TN |
NPI | 1013906809 |
---|---|
Provider Name | Joseph Samuel Smith III |
First Address | Knoxville, TN 37916-2435 |
Second Address | Knoxville, TN 37916-2435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 24/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3013469 | (05) | TN |
A97745 | (02) |