Individual
PAUL GRAYSON SMITH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2121 N OCOEE ST, SUITE 101, CLEVELAND, TN 37311-3953
(423) 472-6548
(423) 472-8318
Mailing address
525 HUNT CLIFF DR NW, CLEVELAND, TN 37311-1642
(423) 903-8339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO1806
TN
207Q00000X
Family Medicine Physician
OS9860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11715949
CAQH
TN
05
—
3719099
—
TN
01
—
4155514
BCBS OF TN
TN
01
—
6635438
CIGNA
TN
01
—
DO1806
STATE LICENSE
TN
01
—
FP62706
WORKERS COMP
TN
01
—
TN0101
JOHN DEERE
TN
01
—
X86491
HEALTH SPRING
TN
Enumeration date
11/10/2006
Last updated
11/19/2007
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