MEDICARE: DR. THOMAS ANDERSON SMITH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	011440	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023011764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS ANDERSON SMITH M.D.

Provider Business Mailing Address
First Line	:	186 HOSPITAL RD
Second Line	:	STE 300
City	:	WINCHESTER
State	:	TN
Zip	:	37398-2473
Country	:	US
Telephone Number	:	931-967-9680
Fax Number	:	931-967-7362

Provider Business Practice Location Address
First Line	:	186 HOSPITAL RD
Second Line	:	STE 300
City	:	WINCHESTER
State	:	TN
Zip	:	37398-2473
Country	:	US
Telephone Number	:	931-967-9680
Fax Number	:	931-967-7362

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2005
Last Update Date	:	07/08/2007

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