Individual
DR. THERESA T SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
587 MCCLELLAN RD, JACKSON, TN 38305-9686
(731) 661-0696
Mailing address
587 MCCLELLAN RD, JACKSON, TN 38305-9686
(731) 661-0696
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD0000022199
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3067011
—
TN
Enumeration date
10/16/2006
Last updated
11/02/2016
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