Provider Demographics
NPI:1023696788
Name:SMOOT, WES EZRA (MD)
Entity type:Individual
Prefix:DR
First Name:WES
Middle Name:EZRA
Last Name:SMOOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:WILBERT
Other - Middle Name:EARL
Other - Last Name:SMOOT
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1005 DR DB TODD JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-3720
Mailing Address - Country:US
Mailing Address - Phone:615-327-6350
Mailing Address - Fax:615-327-6260
Practice Address - Street 1:1005 DR DB TODD JR BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-3720
Practice Address - Country:US
Practice Address - Phone:615-327-6350
Practice Address - Fax:615-327-6260
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty