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Individual

DR. CLARENCE EDWIN SMITH

Active
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Individual

DR. CLARENCE EDWIN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01067962A
IN
2085R0202X
Diagnostic Radiology Physician
42351
TN
2085R0202X
Diagnostic Radiology Physician
Primary
43579
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1513907
TN
05
300102033
IN
05
7100084220
KY
Enumeration date
01/04/2007
Last updated
03/07/2025
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