Individual
JONATHAN L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA - C
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 526-4449
Mailing address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 526-4449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC778
KY
Other
Enumeration date
10/30/2018
Last updated
11/12/2018
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