Individual
SAMUEL A. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5301 VIRGINIA WAY, STE 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Mailing address
5301 VIRGINIA WAY, STE 300, BRENTWOOD, TN 37027-7541
(615) 221-4474
(615) 234-3774
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01025634
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
11267
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
17355
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000004401
TLC TENNCARE
TN
01
—
119453
UNISON TENNCARE
TN
05
—
3041620
—
TN
01
—
3045394
BLUE CROSS
TN
05
—
64745235
—
KY
Enumeration date
09/28/2006
Last updated
07/08/2007
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