Provider Demographics
NPI:1083650634
Name:CLYDE RUFUS SMITH, III
Entity Type:Organization
Organization Name:CLYDE RUFUS SMITH, III
Other - Org Name:GETWELL FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-369-6000
Mailing Address - Street 1:3960 KNIGHT ARNOLD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38118-3035
Mailing Address - Country:US
Mailing Address - Phone:901-369-6000
Mailing Address - Fax:901-369-6001
Practice Address - Street 1:3960 KNIGHT ARNOLD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-3035
Practice Address - Country:US
Practice Address - Phone:901-369-6000
Practice Address - Fax:901-369-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16756174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3722684Medicare ID - Type UnspecifiedGROUP NUMBER