Provider Demographics
NPI:1235998667
Name:SOARES SMITH, ISABELLE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:MARIE
Last Name:SOARES SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NEW YORK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-5225
Mailing Address - Country:US
Mailing Address - Phone:865-835-5850
Mailing Address - Fax:
Practice Address - Street 1:200 NEW YORK AVE STE 200
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-5225
Practice Address - Country:US
Practice Address - Phone:865-835-5850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program