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General NPI Number Information
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NPI Number | 1063499895
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Entity Type | Individual
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Provider Name | STACY L SMITHSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 320 N LORETTO RD
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City | LEBANON
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State | KY
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Zip | 40033-1300
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Country | US
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Telephone | 270-692-6131
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 W MORRIS BLVD STE A
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City | MORRISTOWN
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State | TN
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Zip | 37813-2967
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Country | US
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Telephone | 423-492-7100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 22067
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C4582
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 18049
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD198221
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License Number State | OR
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 68868
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 18049
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License Number State | SC
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