Provider Demographics
NPI:1114965845
Name:SMIY, ALAN N (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:N
Last Name:SMIY
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 1:423 MEDICAL PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5641
Mailing Address - Country:US
Mailing Address - Phone:865-271-6600
Mailing Address - Fax:865-374-2102
Practice Address - Street 1:423 MEDICAL PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5641
Practice Address - Country:US
Practice Address - Phone:865-271-6600
Practice Address - Fax:865-374-2102
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301073629207Q00000X
TNMD62000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ061128Medicaid
MI4390245Medicaid
MI4390245Medicaid
H61023Medicare UPIN
MI0801103432OtherBLUE CROSS BLUE SHIELD