Healthcare Provider Details

I. General information

NPI: 1043326762
Provider Name (Legal Business Name): LEE E SMITH MD & ROBERT M JONES MDPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NEW HOPE RD SUITE 20
PRINCETON WV
24740-2143
US

IV. Provider business mailing address

100 NEW HOPE RD SUITE 20
PRINCETON WV
24740-2143
US

V. Phone/Fax

Practice location:
  • Phone: 304-487-3407
  • Fax: 304-487-2203
Mailing address:
  • Phone: 304-487-3407
  • Fax: 304-487-2203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEE E SMITH
Title or Position: PRESIDENT
Credential: MD
Phone: 304-487-3407