MEDICARE: MRS. LYNDSAY MICHELE SMITH

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	208000000X	Pediatrics Physician	54459	TN

General Provider Information

NPI Number	:	1922441120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNDSAY MICHELE SMITH

Provider Business Mailing Address
First Line	:	PO BOX 655
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-0655
Country	:	US
Telephone Number	:	731-926-8985
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 ENOCH BLVD
Second Line	:
City	:	SAVANNAH
State	:	TN
Zip	:	38372-2240
Country	:	US
Telephone Number	:	731-925-2300
Fax Number	:

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

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	08/26/2024

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