Individual
DR. KIMBERLY KAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
979 E. THIRD STREET, SUITE# C-830, CHATTANOOGA, TN 37403
(423) 778-9001
(423) 778-9014
Mailing address
975 E. THIRD STREET, ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403
(423) 778-9001
(423) 778-9014
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
037384
GA
2084N0400X
Neurology Physician
Primary
56567
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000557807E
—
GA
01
—
01946877
AMERIGROUP
GA
01
—
928906
WELLCARE
GA
01
—
P01332066
RR MEDICARE
GA
Enumeration date
01/24/2006
Last updated
05/02/2018
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