Dr Stacy L Smithson, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Lebanon, Kentucky. He went to University Of Illinois College Of Med (chi/peor/rock/chm-urb) and graduated in 1989 and has 37 years of diverse experience with area of expertise as Obstetrics/gynecology. He is a member of the group practice Northeastern Nevada Physician Practices Llc and his current practice location is
320 N Loretto Rd, Lebanon, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(270) 692-6131.
Dr Stacy L Smithson is licensed to practice in Kentucky (license number C4582) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063499895.
Physician's Profile
| Full Name | Dr Stacy L Smithson |
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| Gender | Male |
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| Speciality | Obstetrics/gynecology |
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| Experience | 37 Years |
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| Location | 320 N Loretto Rd, Lebanon, Kentucky |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Stacy L Smithson attended and graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 1989
NPI Data:
- NPI Number: 1063499895
- Provider Enumeration Date: 12/22/2005
- Last Update Date: 10/28/2025
Medicare PECOS Information:
- PECOS PAC ID: 1456329002
- Enrollment ID: I20251112004082
Medical Identifiers
Medical identifiers for Dr Stacy L Smithson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063499895 | NPI | - | NPPES |
| I80496 | Medicaid | SC | |
| GP3644 | Medicaid | SC | |
| Q084683 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207V00000X | Obstetrics & Gynecology | 22067 (New Hampshire) | Secondary |
| 207V00000X | Obstetrics & Gynecology | C4582 (Kentucky) | Primary |
| 207V00000X | Obstetrics & Gynecology | 18049 (South Carolina) | Secondary |
| 207V00000X | Obstetrics & Gynecology | MD198221 (Oregon) | Secondary |
| 207V00000X | Obstetrics & Gynecology | 68868 (Tennessee) | Secondary |
| 174400000X | Specialist | 18049 (South Carolina) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Northeastern Nevada Physician Practices Llc | 3779649223 | 20 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Stacy L Smithson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Stacy L Smithson, MD
1621 W Morris Blvd Ste A,
Morristown, TN 37813-2967
Ph: (423) 492-7100 | Dr Stacy L Smithson, MD
320 N Loretto Rd,
Lebanon, KY 40033-1300
Ph: (270) 692-6131 |
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