Raymond Shane Smith in Johnson City - Physician Assistant
Raymond Shane Smith - NPI 1104006592
Raymond Shane Smith is a Physician Assistant in Johnson City, Tennessee. Raymond Shane Smith practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Raymond Shane Smith is 1104006592. The last update date is 2017-02-23.
Raymond Shane Smith's current location address is 410 N State Of Franklin Rd, Johnson City, Tennessee. You can contact this provider via phone number 4234312477 and fax number 4234312478. The mailing address for Raymond Shane Smith is 410 N State Of Franklin Rd, Johnson City, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Raymond Shane Smith |
|---|---|
| Address | 410 N State Of Franklin Rd, Johnson City, Tennessee |
| Phone Number | 4234312477 |
| Fax Number | 4234312478 |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1104006592 |
|---|---|
| Provider Enumeration Date | 2007-11-14 |
| Last Updated Date | 2017-02-23 |
Provider Mailing Address Detail
| Address | 410 N State Of Franklin Rd |
|---|---|
| City | Johnson City |
| State | Tennessee (TN) |
| Post Code | 376046971 |
| Phone Number | 4234312477 |
| Fax Number | 4234312478 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 2338 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1104006592 | NC | -- | |
| Q002626 | TN | -- | |
| 1104006592 | VA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Raymond Shane Smith by the Centers for Medicare & Medicaid Services?
The Raymond Shane Smith has been issued the NPI (National Provider Identifier) 1104006592 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete address where Raymond Shane Smith is physically located?
The Raymond Shane Smith is situated at the following address: 410 N State Of Franklin Rd, Johnson City, TN 376046971.
What is Raymond Shane Smith's specialized field of practice, and what is the corresponding taxonomy classification code?
The Raymond Shane Smith's area of specialization is Physician Assistant, and the corresponding taxonomy code that categorizes this field of practice is 363A00000X.
When was the Raymond Shane Smith's 1104006592 issued?
The Raymond Shane Smith's 1104006592 was issued on 2007-11-14.
When was the information pertaining to Raymond Shane Smith most recently updated or revised?
The details related to Raymond Shane Smith, including its address, specialty, and other relevant information, were last updated or revised on 2017-02-23.
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