Healthcare Provider Details

I. General information

NPI: 1780771824
Provider Name (Legal Business Name): PAMELA ANN SMITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 POPLAR ST
MURRAY KY
42071-2432
US

IV. Provider business mailing address

201 PARK ST
BOWLING GREEN KY
42101-1742
US

V. Phone/Fax

Practice location:
  • Phone: 270-762-1597
  • Fax: 270-752-2860
Mailing address:
  • Phone: 270-781-5111
  • Fax: 270-780-0474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number50487
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: