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General NPI Number Information
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NPI Number | 1659575181
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Entity Type | Organization
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Legal Business Name | BOWDOIN G. SMITH D.O.,P.C.
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 9 MAGGART CIR
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City | CARTHAGE
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State | TN
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Zip | 37030-2151
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Country | US
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Telephone | 615-735-0202
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Fax | 615-735-3011
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Provider Business Mailing Address
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Address Line | 9 MAGGART CIR
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City | CARTHAGE
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State | TN
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Zip | 37030-2151
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Country | US
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Telephone | 615-735-0202
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Fax | 615-735-3011
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. BOWDOIN GRAYSON SMITH
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Credential | D.O.
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Telephone | 615-735-0202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO741
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License Number State | TN
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