=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023347986
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN J SMITH, M.D., PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2009
-----------------------------------------------------
Last Update Date | 12/28/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9239 PARK WEST BLVD SUITE 201
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-246-6700
-----------------------------------------------------
Fax | 864-246-6702
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9239 PARK WEST BLVD SUITE 201
-----------------------------------------------------
City | KNOXVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 865-246-6700
-----------------------------------------------------
Fax | 864-246-6702
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/SURGEON
-----------------------------------------------------
Name | STEVEN JAMES SMITH
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 865-246-6700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0122X
-----------------------------------------------------
Taxonomy Name | Plastic and Reconstructive Surgery Physician
-----------------------------------------------------
License Number | 14833
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------