Individual
MR. JAMES M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN-CRNA
Contact information
Practice address
18797 ALBERTA ST, ONEIDA, TN 37841-2127
(865) 777-0909
(865) 777-0910
Mailing address
12752 KINGSTON PIKE, STE E202, KNOXVILLE, TN 37934-0948
(865) 777-0909
(865) 777-0910
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4873A
KY
367500000X
Certified Registered Nurse Anesthetist
APN11282
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
RN106433
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000522382
BLUE CROSS/BLUE SHIELD
KY
05
—
1505098
—
TN
01
—
4096038
BC INDIVIDUAL NUMBER
TN
01
—
4175840
BLUE CROSS/BLUE SHIELD
TN
05
—
74002684
—
KY
Enumeration date
11/10/2006
Last updated
03/02/2011
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