| Doctor Name: | MARTHA SMITH |
| NPI Number: | 1083716450 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CFNP |
| License Number: | R678562 |
| Business Practice Address: | 360 Simpson Highway 149 Suite 150 Magee, MS - 391113841 |
| Business Phone Number: | 6018491236 |
| Business Fax Number: | 6018491890 |
| Mailing Address: | 360 Simpson Highway 149, Suite 150 MAGEE |
| State: | MS |
| Postal Code: | 391113841 |
| Phone Number: | 6018491236 |
| Fax Number: | 6018491890 |
| NPI Enumeration Date: | 09/05/2006 |
| NPI Last Update Date: | 01/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R678562 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |