Provider Demographics
NPI:1184691560
Name:SMITH, SCOTT TRACY (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:TRACY
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 1:1600 ACCELERATOR WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-3078
Mailing Address - Country:US
Mailing Address - Phone:865-546-2663
Mailing Address - Fax:865-546-9047
Practice Address - Street 1:1600 ACCELERATOR WAY STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-3078
Practice Address - Country:US
Practice Address - Phone:865-546-2663
Practice Address - Fax:865-546-9047
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29568207XX0801X
TNMD29568207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5649534OtherAETNA
TN0940044OtherUNITED HEALTH CARE
TN200029211OtherRAILROAD MEDICARE
TNTN0132OtherJOHN DEERE HEALTHCARE
TN3813957Medicaid
TN100021204OtherTENNCARE
TN3071418OtherBLUE CROSS BLUE SHIELD
KY64130289Medicaid
TN200029211OtherRAILROAD MEDICARE
TN103I204499Medicare PIN
TN3813957Medicaid
TN103I205865Medicare PIN
TN100021204OtherTENNCARE
TN3071418OtherBLUE CROSS BLUE SHIELD
3813958Medicare ID - Type Unspecified
3813956Medicare ID - Type Unspecified
3813957Medicare ID - Type Unspecified
TNTN0132OtherJOHN DEERE HEALTHCARE