Provider Demographics
NPI:1750348777
Name:SMITH, LENWOOD PERKINS JR (MD)
Entity type:Individual
Prefix:DR
First Name:LENWOOD
Middle Name:PERKINS
Last Name:SMITH
Suffix:JR
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 1:210 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7150
Mailing Address - Country:US
Mailing Address - Phone:615-636-9050
Mailing Address - Fax:
Practice Address - Street 1:1417 W PETTIGREW ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4898
Practice Address - Country:US
Practice Address - Phone:919-286-7705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15420207T00000X
NC2013-02164207T00000X, 208600000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18426OtherBCBS NC
NC1750348777Medicaid
SC154200Medicaid
SC154200Medicaid
NC1750348777Medicaid
NC18426OtherBCBS NC
E88414Medicare UPIN
SCE884148946Medicare PIN