Individual
TEVIS CLARK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA, RN
Contact information
Practice address
250 PARK ST, BOWLING GREEN, KY 42101-1760
(270) 745-1000
Mailing address
680 RALPH MORRIS RD, GLASGOW, KY 42141-9647
(270) 670-5267
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
119117
KY
Other
Enumeration date
12/14/2017
Last updated
12/14/2017
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