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Individual
JERRY LEE SMITH
Active
Individual
JERRY LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
MD0000026739
TN
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
041960
GA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD26739
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10076869
AMERIGROUP
GA
01
—
376910
WELLCARE
GA
01
—
4126985
BCBSTN
TN
Enumeration date
03/27/2006
Last updated
08/10/2021
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