Smith, Theresa T

Smith, Theresa T is an sole proprietor health care provider with primary practice located at 587 Mcclellan Rd , Jackson TN 38305-9686. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Smith, Theresa T can be contacted via phone (731) 661-0696.

Contact Information

Primary practice address
587 Mcclellan Rd Jackson TN 38305-9686
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD0000022199 Tennessee

Profile Details

NPI number 1558451773
LBN Legal business name Smith, Theresa T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 16th, 2006
Last updated Nov 2nd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558451773 NPPES
Tennessee MEDICAID 3067011

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