Healthcare Provider Details

I. General information

NPI: 1316477078
Provider Name (Legal Business Name): GRAHM SMITH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2017
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 N MAIN ST STE B
SHELBYVILLE TN
37160-2392
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 931-685-2022
  • Fax:
Mailing address:
  • Phone:
  • Fax: 615-322-5048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3313
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: