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NPI Code Detail

MEDICARE: MRS. ELIZABETH C. SMITH M.D.

MEDICARE:  MRS. ELIZABETH C. 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
1174400000XSpecialistTN

General Provider Information

NPI Number : 1922009521
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH C. SMITH M.D.
Provider Business Mailing Address
First Line : 1817 MILLBROOK DR
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-1486
Country : US
Telephone Number : 423-282-5888
Fax Number :
Provider Business Practice Location Address
First Line : 302 WESLEY ST
Second Line : SUITE 10
City : JOHNSON CITY
State : TN
Zip : 37601-1740
Country : US
Telephone Number : 423-928-9007
Fax Number : 423-928-9249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 03/12/2008

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Directions to “ MRS. ELIZABETH C. SMITH M.D.” Practice Location

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