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Individual

MR. TAYLOR MICHAEL SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C, ATC

Contact information

Practice address
28 MEDICAL CENTER DR, JACKSON, TN 38301-3947
(731) 427-9971
(731) 427-9973
Mailing address
28 MEDICAL CENTER DR, JACKSON, TN 38301-3947
(731) 427-9971
(731) 427-9973

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4638
TN
363AM0700X
Medical Physician Assistant
4638
TN
363AS0400X
Surgical Physician Assistant
4638
TN

Other

Enumeration date
07/30/2020
Last updated
03/06/2024
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