Individual
JEFFREY JAMES SMYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
830 PENNSYLVANIA AVE STE 204, CHARLESTON, WV 25302-3389
(304) 388-2980
Mailing address
830 PENNSYLVANIA AVE STE 204, CHARLESTON, WV 25302-3389
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2595
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1180976
NCCPA CERTIFICATION
—
01
—
2595
MEDICAL LICENSE
WV
Enumeration date
05/09/2022
Last updated
05/09/2022
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