Healthcare Provider Details

I. General information

NPI: 1124722673
Provider Name (Legal Business Name): TREVOR SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

431 PEBBLE PATH
NASHVILLE TN
37203-7873
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-4751
  • Fax:
Mailing address:
  • Phone: 813-527-1175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number6847
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: