Individual
SAMUEL M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 E THIRD S, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
051741
GA
207L00000X
Anesthesiology Physician
Primary
MD21745
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000587716A
—
GA
05
—
009601310
—
AL
01
—
0168146
BCBS
TN
01
—
050047704
RR MEDICARE
—
05
—
3061512
—
TN
05
—
5902182
—
NC
01
—
N374698
WELLCARE (GA MEDICAID)
GA
01
—
XXX-XX-9544
TRICARE
—
Enumeration date
11/16/2006
Last updated
01/14/2010
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