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General NPI Number Information
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NPI Number | 1912186636
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Entity Type | Organization
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Legal Business Name | MELISSA SMITH, D.O., PSC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2222 WINCHESTER AVE STE C
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City | ASHLAND
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State | KY
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Zip | 41101-7847
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Country | US
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Telephone | 606-325-8364
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Fax | 606-327-8893
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Provider Business Mailing Address
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Address Line | 2222 WINCHESTER AVE STE C
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City | ASHLAND
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State | KY
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Zip | 41101-7847
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Country | US
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Telephone | 606-325-8364
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Fax | 606-327-8893
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELISSA SMITH
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Credential | D.O.
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Telephone | 606-325-8364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 02943
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License Number State | KY
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