Individual
LORI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6005 PARK AVE STE 400, MEMPHIS, TN 38119-5214
(901) 767-9500
Mailing address
956 JOHN IVY RD, CARTHAGE, MS 39051-7213
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
23602
TN
208D00000X
General Practice Physician
23602
TN
208VP0000X
Pain Medicine Physician
Primary
23602
TN
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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