Provider Demographics
NPI:1538332010
Name:SMITH, DAVID E (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:647 DUNLOP LN STE 209
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5193
Mailing Address - Country:US
Mailing Address - Phone:931-245-1920
Mailing Address - Fax:931-245-1920
Practice Address - Street 1:647 DUNLOP LN
Practice Address - Street 2:SUITE 209
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5165
Practice Address - Country:US
Practice Address - Phone:931-245-1920
Practice Address - Fax:931-245-1920
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY244013213E00000X
IA0795T213E00000X
TN693213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist