Healthcare Provider Details

I. General information

NPI: 1194788547
Provider Name (Legal Business Name): JANET LEE SMITH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 05/08/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 PINE ST
FRANKLIN WV
26807-6630
US

IV. Provider business mailing address

PO BOX 100
FRANKLIN WV
26807-0100
US

V. Phone/Fax

Practice location:
  • Phone: 304-358-2355
  • Fax: 855-332-1388
Mailing address:
  • Phone: 304-358-2355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number102993
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110005314
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: