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General NPI Number Information
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NPI Number | 1992818975
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Entity Type | Individual
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Provider Name | AUDREY MARCELLE SMITH M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 4409 CENTRAL AVENUE PIKE # 102103
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City | KNOXVILLE
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State | TN
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Zip | 37912-4081
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Country | US
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Telephone | 865-378-6929
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 SPRING PASS WAY
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City | KNOXVILLE
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State | TN
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Zip | 37919-9044
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Country | US
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Telephone | 865-414-4151
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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 | MD028569
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | MD028569
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD028569
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License Number State | TN
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