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General NPI Number Information
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NPI Number | 1700163706
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Entity Type | Individual
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Provider Name | JOHN TIMOTHY SMITH DPH
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Gender | Male
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 400 W MEADECREST DR
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City | KNOXVILLE
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State | TN
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Zip | 37923-2432
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Country | US
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Telephone | 865-531-0033
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Fax |
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Provider Business Mailing Address
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Address Line | 9200 MIDDLEBROOK PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37931-4701
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Country | US
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Telephone | 865-531-0033
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0000007482
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13679
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License Number State | LA
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