Individual
AILISA HIPP SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
915 TATE BLVD SE, SUITE 186, HICKORY, NC 28602-4042
(828) 324-0359
(828) 324-0358
Mailing address
915 TATE BLVD SE, SUITE 186, HICKORY, NC 28602-4042
(828) 324-0359
(828) 324-0358
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2008-00610
NC
209800000X
Legal Medicine (M.D./D.O.) Physician
2008-00610
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022135
MEDICARE
NC
05
—
5909242
—
NC
01
—
CN8132
RAILROAD MEDICARE
NC
Enumeration date
02/28/2007
Last updated
03/07/2023
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