Individual
DR. WAYNE O SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Mailing address
1009 NOVUS DR STE 2, JOHNSON CITY, TN 37604-8237
(423) 283-0776
(423) 283-0549
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD0000047334
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TN
Enumeration date
11/23/2007
Last updated
07/27/2021
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