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NPI Code Detail

MEDICARE: MRS. ANGELA D. SMITH CFOM, CFTS

MEDICARE: MRS. ANGELA D. SMITH CFOM, CFTS
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
1174400000XSpecialist

Other Identifiers

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

General Provider Information

NPI Number : 1669780961
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA D. SMITH CFOM, CFTS
Provider Business Mailing Address
First Line : 1334 MACKEY BRANCH DR
Second Line : SUITE 104
City : CHATTANOOGA
State : TN
Zip : 37421-3471
Country : US
Telephone Number : 423-296-2604
Fax Number : 423-296-2607
Provider Business Practice Location Address
First Line : 1334 MACKEY BRANCH DR
Second Line : SUITE 104
City : CHATTANOOGA
State : TN
Zip : 37421-3471
Country : US
Telephone Number : 423-296-2604
Fax Number : 423-296-2607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2010
Last Update Date : 04/29/2016

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