Most Relevant Information
Provider Data
| NPI Number: | 1003576414 |
| Provider Name: | CHARLES JASON SMITH NP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | 107558 |
Most Important Dates
| Enumeration Date: | 12/27/2021 |
| Last Updated: | 02/08/2023 |
Provider Practice Location
4540 US ROUTE 60
HUNTINGTON
WV
257051936
Practice Location Phone/Fax
| Phone: | 3045257111 |
| Fax: |
Provider Mailing Location
4540 US ROUTE 60
HUNTINGTON
WV
257051936
Provider Mailing Phone/Fax
| Phone: | 3045257111 |
| Fax: | 3047361589 |