MEDICARE: ADAM M SMITH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	MD38676	TN
2	207X00000X	Orthopaedic Surgery Physician	MD38676	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861409245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM M SMITH MD

Provider Business Mailing Address
First Line	:	24 PHYSICIANS DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2070
Country	:	US
Telephone Number	:	731-661-9825
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 PHYSICIANS DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38305-2070
Country	:	US
Telephone Number	:	731-661-9825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	11/02/2015

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Directions to “ ADAM M SMITH MD” Practice Location

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