Clyde E Smith, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

08897 Issued in TN

Practice address

27 Medical Center Dr
Jackson, TN 38301-3949

Phone

(731) 424-1001

NPI assigned

May 19, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Specialty Clinic P.C.

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1104877703

  Hematology & Oncology

  NPD
• West Tennessee Medical Group Inc

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1053615955
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053365809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MEDICAL CENTER DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013949",
            "telephone_number": "731-424-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MEDICAL CENTER DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013949",
            "telephone_number": "731-424-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CLYDE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "08897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3172162",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam M Smith, MD
• Autumn N Smith, BSW
• Braden Reid Smith, N.P.
• Brynn Shellene Smith, OTR/L
• Clinton Smith
• Delia A Smith
• Garrison Berry Smith, M.D.
• Hannah Marie B Smith, RBT
• Helen Smith, PT
• Kathy Dawn Smith

• Hematology & Oncology Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Hematology & Oncology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.