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Individual

DR. MICHELLE DEANN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
227 BURLEY AVE, HOPKINSVILLE, KY 42240-8725
(270) 887-5640
(270) 886-5371
Mailing address
102 W 18TH ST, HOPKINSVILLE, KY 42240-1961
(270) 707-2100
(270) 707-2103

Taxonomy

Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
26593
SC
207NS0135X
Procedural Dermatology Physician
Primary
54389
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
265938
SC
Enumeration date
02/17/2006
Last updated
09/21/2020
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