Provider Demographics
NPI:1770559502
Name:SMITHEY, BRANDON ERIC (MD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:ERIC
Last Name:SMITHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9303 PARK WEST BOULEVARD, SUITE 200
Mailing Address - Street 2:PATHOLOGY LABORATORIES WEST, PLLC
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923
Mailing Address - Country:US
Mailing Address - Phone:865-690-2111
Mailing Address - Fax:865-373-1615
Practice Address - Street 1:9352 PARK WEST BOULEVARD
Practice Address - Street 2:PARKWEST MEDICAL CENTER DEPARTMENT OF PATHOLOGY
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923
Practice Address - Country:US
Practice Address - Phone:865-373-1604
Practice Address - Fax:865-373-1615
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2002005137207ZP0102X
TN34707207ZP0102X, 207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209079904Medicaid
MO209079904Medicaid
MO919061698Medicare PIN
MOI10859Medicare UPIN
MO919061465Medicare PIN