Provider Demographics
NPI:1851398259
Name:SMITH, ALLEN CARMICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:CARMICHAEL
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:PO BOX 94670
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73143-4670
Mailing Address - Country:US
Mailing Address - Phone:405-682-3303
Mailing Address - Fax:
Practice Address - Street 1:744 MIDDLE CREEK RD STE 208
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-5036
Practice Address - Country:US
Practice Address - Phone:865-446-9725
Practice Address - Fax:865-446-9726
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36975207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN37066301OtherMEDICARE GROUP
TN3000603Medicare PIN
TN37066301OtherMEDICARE GROUP