Provider Demographics
NPI:1083608905
Name:SMALLEY, LEE ALAN (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:ALAN
Last Name:SMALLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 VERMONT AVE
Mailing Address - Street 2:THE EYE CENTER OF OAK RIDGE PC
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6478
Mailing Address - Country:US
Mailing Address - Phone:865-482-8890
Mailing Address - Fax:865-482-7400
Practice Address - Street 1:90 VERMONT AVE
Practice Address - Street 2:THE EYE CENTER OF OAK RIDGE PC
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6478
Practice Address - Country:US
Practice Address - Phone:865-482-8890
Practice Address - Fax:865-482-7400
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000010171207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3162199Medicaid
3162199Medicare PIN
TN3162199Medicaid