Provider Demographics
NPI:1033105689
Name:SMITH, TERRY W (MD)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2205 MCCALLIE AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3334
Mailing Address - Country:US
Mailing Address - Phone:423-493-1700
Mailing Address - Fax:423-493-1769
Practice Address - Street 1:2205 MCCALLIE AVE STE 310
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3334
Practice Address - Country:US
Practice Address - Phone:423-493-1700
Practice Address - Fax:423-493-1769
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
TNMD15659207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB58865Medicare UPIN