Provider Demographics
NPI:1871835892
Name:SMITH, ROBERT MAXWELL (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MAXWELL
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 DEEP WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-6309
Mailing Address - Country:US
Mailing Address - Phone:615-591-3138
Mailing Address - Fax:615-591-1275
Practice Address - Street 1:1004 DEEP WOODS TRL
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-6309
Practice Address - Country:US
Practice Address - Phone:615-591-3138
Practice Address - Fax:615-591-1275
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1312207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease