| Doctor Name: | LISA MARIE SMITH |
| NPI Number: | 1164512935 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 3512 |
| Business Practice Address: | 520 Main St Dowagiac, MI - 490471762 |
| Business Phone Number: | 2697833052 |
| Business Fax Number: | |
| Mailing Address: | 5943 Stadium Dr, KALAMAZOO |
| State: | MI |
| Postal Code: | 490093016 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 07/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 3512 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |