MEDICARE: DRS ALBRIGHT, SMITH & PECK

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	1223P0106X	Oral and Maxillofacial Pathology Dentistry

General Provider Information

NPI Number	:	1386848638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS ALBRIGHT, SMITH & PECK

Provider Business Mailing Address
First Line	:	766 S WHITE STATION RD
Second Line	:	SUITE #1
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4579
Country	:	US
Telephone Number	:	901-685-8090
Fax Number	:

Provider Business Practice Location Address
First Line	:	766 S WHITE STATION RD
Second Line	:	SUITE #1
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4579
Country	:	US
Telephone Number	:	901-685-8090
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIAL SPECIALIST
Name	:	MRS. LORI LYNN REZABEK
Credential	:
Telephone Number	:	901-685-8090

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	08/22/2020

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