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General NPI Number Information
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NPI Number | 1629327135
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Entity Type | Individual
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Provider Name | EDITH SMITH M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 10621 CHEVY DR SUITE A
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City | KNOXVILLE
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State | TN
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Zip | 37922-3105
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Country | US
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Telephone | 865-385-1994
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Fax |
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Provider Business Mailing Address
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Address Line | 5620 WASHINGTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37918-7007
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Country | US
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Telephone | 865-385-1994
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 24548
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 24548
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License Number State | TN
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