Provider Demographics
NPI:1497715767
Name:SMITH, TRUEMAN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:TRUEMAN
Middle Name:DAVID
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 N WASHINGTON AVE
Mailing Address - Street 2:SUITE 265
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2603
Mailing Address - Country:US
Mailing Address - Phone:931-854-9432
Mailing Address - Fax:931-854-9434
Practice Address - Street 1:315 N WASHINGTON AVE
Practice Address - Street 2:SUITE 265
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2603
Practice Address - Country:US
Practice Address - Phone:931-854-9432
Practice Address - Fax:931-854-9434
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25583208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3084649Medicaid
TNF96517Medicare UPIN
TN3084649Medicaid