Provider Demographics
NPI:1043209265
Name:SMITH, DANIEL R (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1032 MCCALLIE AVENUE
Mailing Address - Street 2:STE 300
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403
Mailing Address - Country:US
Mailing Address - Phone:423-693-2800
Mailing Address - Fax:423-693-2838
Practice Address - Street 1:1032 MCCALLIE AVENUE
Practice Address - Street 2:STE 300
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-693-2800
Practice Address - Fax:423-693-2838
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2016-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN25994207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3089351Medicare ID - Type Unspecified
TNA97581Medicare UPIN