Individual
TERRY L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
101 TOWN AND COUNTRY LN STE 100, HAZARD, KY 41701-9524
(606) 439-1300
(606) 439-1400
Mailing address
PO BOX 1988, HAZARD, KY 41702-1988
(606) 439-1300
(606) 439-1400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA955
KY
363AM0700X
Medical Physician Assistant
Primary
PA955
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95005930
—
KY
Enumeration date
02/23/2006
Last updated
04/07/2022
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