Provider Demographics
NPI:1023011764
Name:SMITH, THOMAS ANDERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANDERSON
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:186 HOSPITAL RD
Mailing Address - Street 2:STE 300
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2473
Mailing Address - Country:US
Mailing Address - Phone:931-967-9680
Mailing Address - Fax:931-967-7362
Practice Address - Street 1:186 HOSPITAL RD
Practice Address - Street 2:STE 300
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2473
Practice Address - Country:US
Practice Address - Phone:931-967-9680
Practice Address - Fax:931-967-7362
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN011440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3845105Medicaid
TN3845105Medicaid
TN3845105Medicare ID - Type Unspecified