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Individual

DR. PAUL GRAYSON SMITH JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2121 N OCOEE ST, SUITE 101, CLEVELAND, TN 37311-3953
(423) 472-6548
(423) 472-8318
Mailing address
2121 N OCOEE ST, SUITE 101, CLEVELAND, TN 37311-3953
(423) 472-6548
(423) 472-8318

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO256
TN
207Q00000X
Family Medicine Physician
OS3710
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0140208
UNITED HEALTHCARE
TN
01
10811010
CAQH
TN
01
2000307
BCBS OF TN
TN
05
3719099
TN
01
FP62706
WORKER'S COMP
TN
01
TN0101
JOHN DEERE HEALTH
TN
Enumeration date
06/08/2006
Last updated
07/09/2007
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