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Individual

GRAHAM SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
803 POPLAR ST, MURRAY, KY 42071-2432
(270) 762-1100
Mailing address
15 BEAR RUN TRL, BENTON, KY 42025-5833

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
29352
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000331843
BLUE CROSS BLUE SHIELD
KY
05
4047215
TN
05
64293525
KY
01
P00210552
RAILROAD MEDICARE
KY
Enumeration date
06/03/2006
Last updated
03/10/2008
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