| Doctor Name: | CHARLES LEE SMITH |
| NPI Number: | 1841419058 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 832 |
| Business Practice Address: | 401 Guffey St Fairmont, WV - 265544029 |
| Business Phone Number: | 3043632500 |
| Business Fax Number: | 3043630263 |
| Mailing Address: | 401 Guffey St, FAIRMONT |
| State: | WV |
| Postal Code: | 265544029 |
| Phone Number: | 3043632500 |
| Fax Number: | 3043630263 |
| NPI Enumeration Date: | 04/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 832 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |