Individual
JACQUELINE T SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1502 SPARTA ST, MC MINNVILLE, TN 37110-1317
(931) 473-9528
(931) 473-1618
Mailing address
1502 SPARTA ST, MC MINNVILLE, TN 37110-1317
(931) 473-9528
(931) 473-1618
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TN262
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3351150
—
TN
Enumeration date
06/12/2006
Last updated
09/23/2015
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