| NPI | 1922463470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERT JACKSON SMITH Provider/Owner 423-926-2358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 42425) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2022-06-07 |