Provider Demographics
NPI:1306726948
Name:SMITH, DOCK AUSTIN
Entity type:Individual
Prefix:
First Name:DOCK
Middle Name:AUSTIN
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 NEW HIGHWAY 96 W # 103
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-2554
Mailing Address - Country:US
Mailing Address - Phone:615-552-7080
Mailing Address - Fax:516-299-6097
Practice Address - Street 1:511 NEW HIGHWAY 96 W # 103
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-2554
Practice Address - Country:US
Practice Address - Phone:615-552-7080
Practice Address - Fax:516-299-6097
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician