MEDICARE: M KEVIN SMITH MD PC

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	207R00000X	Internal Medicine Physician	MD27936	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110215825	OTHER	TN	MCARE RAILROAD
2	3158590	OTHER		BCBS

General Provider Information

NPI Number	:	1548237266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M KEVIN SMITH MD PC

Provider Business Mailing Address
First Line	:	PO BOX 50976
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-9998
Country	:	US
Telephone Number	:	615-383-4748
Fax Number	:	615-383-9293

Provider Business Practice Location Address
First Line	:	4230 HARDING PIKE STE 104
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-4900
Country	:	US
Telephone Number	:	615-383-4748
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	LISA SMITH
Credential	:
Telephone Number	:	615-612-3541

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	12/05/2022

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