Provider Demographics
NPI:1386848638
Name:DRS ALBRIGHT, SMITH & PECK
Entity Type:Organization
Organization Name:DRS ALBRIGHT, SMITH & PECK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:REZABEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-685-8090
Mailing Address - Street 1:766 S WHITE STATION RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4579
Mailing Address - Country:US
Mailing Address - Phone:901-685-8090
Mailing Address - Fax:
Practice Address - Street 1:766 S WHITE STATION RD
Practice Address - Street 2:SUITE #1
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4579
Practice Address - Country:US
Practice Address - Phone:901-685-8090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN=========OtherTAX ID NUMBER