Individual
LISA KAY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
75 SHELDON AVE SE STE 100, GRAND RAPIDS, MI 49503-4224
(616) 391-6120
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301080102
MI
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
4301080102
MI
Other
Enumeration date
05/25/2006
Last updated
07/14/2025
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