| Paul Grayson Smith, Jr., D.o., P.c. | |
|
2121 N Ocoee St Suite 101 Cleveland TN 37311-3953 | |
| (423) 472-6548 | |
| (423) 472-8318 |
| Full Name | Paul Grayson Smith, Jr., D.o., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2121 N Ocoee St, Cleveland, Tennessee |
| Authorized Official Name and Position | Angela Dawn Digiammarino (PRACTICE MANAGER) |
| Authorized Official Contact | 4234726548 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Grayson Smith, Jr., D.o., P.c. 2121 N Ocoee St Suite 101 Cleveland TN 37311-3953 Ph: (423) 472-6548 | Paul Grayson Smith, Jr., D.o., P.c. 2121 N Ocoee St Suite 101 Cleveland TN 37311-3953 Ph: (423) 472-6548 |
| NPI Number | 1952472185 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5294754792 |
|---|---|
| Medicare Enrollment ID | O20051114001051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952472185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO256 (Tennessee) | Primary |
| Provider Name | Paul G Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669543807 PECOS PAC ID: 9133214166 Enrollment ID: I20071004000763 |
| Provider Name | Paul Grayson Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215978747 PECOS PAC ID: 1456370956 Enrollment ID: I20110111000496 |
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