Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD010986 | TN |
NPI | 1013927789 |
---|---|
Provider Name | William J. Smead |
First Address | Greeneville, TN 37745-6219 |
Second Address | Greeneville, TN 37745-6219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 30/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31656001 | (05) | TN |
B03117 | (02) | TN |