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General NPI Number Information
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NPI Number | 1528006376
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Entity Type | Individual
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Provider Name | GRAHAM SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 803 POPLAR ST
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City | MURRAY
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State | KY
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Zip | 42071-2432
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Country | US
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Telephone | 270-762-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 15 BEAR RUN TRL
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City | BENTON
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State | KY
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Zip | 42025-5833
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 29352
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License Number State | KY
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