=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255475810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SMZ SPECIALISTS, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2007
-----------------------------------------------------
Last Update Date | 03/04/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2996 KATE BOND RD STE 209
-----------------------------------------------------
City | BARTLETT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38133-4062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-791-0244
-----------------------------------------------------
Fax | 901-791-0305
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2996 KATE BOND RD STE 209
-----------------------------------------------------
City | BARTLETT
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38133-4062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-791-0244
-----------------------------------------------------
Fax | 901-791-0305
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. SYED H SHIRAZEE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 901-791-0244
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 28214
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------