Individual
DR. PAULA RENEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
(423) 431-1810
(423) 431-1811
Mailing address
408 N STATE OF FRANKLIN RD, SUITE 24, JOHNSON CITY, TN 37604-6089
(423) 431-1810
(423) 431-1811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101102663
VA
207R00000X
Internal Medicine Physician
Primary
47736
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043211204
—
VA
05
—
1525800
—
TN
05
—
7100240050
—
KY
01
—
P00984680
RR MEDICARE
TN
Enumeration date
08/09/2005
Last updated
12/23/2014
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