MEDICARE: MATTHEW SMILEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1437862489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW SMILEY

Provider Business Mailing Address
First Line	:	1019 BIG SANDY RIVER RD
Second Line	:
City	:	FORT GAY
State	:	WV
Zip	:	25514-7021
Country	:	US
Telephone Number	:	304-521-5771
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 BIG SANDY RIVER RD
Second Line	:
City	:	FORT GAY
State	:	WV
Zip	:	25514-7021
Country	:	US
Telephone Number	:	304-521-5771
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2023
Last Update Date	:	05/16/2025

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Directions to “ MATTHEW SMILEY ” Practice Location

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