| Doctor Name: | MRS. LISA M SMITH |
| NPI Number: | 1114916475 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PAC |
| License Number: | 002904 |
| Business Practice Address: | 107 Main St Plains, GA - 317805570 |
| Business Phone Number: | 2298247757 |
| Business Fax Number: | 2298243497 |
| Mailing Address: | Po Box 196, PLAINS |
| State: | GA |
| Postal Code: | 317800196 |
| Phone Number: | 2298243438 |
| Fax Number: | |
| NPI Enumeration Date: | 10/19/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 002904 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |