| Doctor Name: | VICKI P. SMYTHE |
| NPI Number: | 1073630711 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 1209-023 |
| Business Practice Address: | 74 Eclipse Ctr Beloit, WI - 535113550 |
| Business Phone Number: | 6083610311 |
| Business Fax Number: | 6083610312 |
| Mailing Address: | 819 N Garfield Ave, JANESVILLE |
| State: | WI |
| Postal Code: | 535451842 |
| Phone Number: | |
| Fax Number: | 6087568488 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1209-023 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |