Provider Demographics
NPI:1336472174
Name:SMITH, JOEL ERIC (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:ERIC
Last Name:SMITH
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:363 FREMONT ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3389
Mailing Address - Country:US
Mailing Address - Phone:269-245-8310
Mailing Address - Fax:269-245-8345
Practice Address - Street 1:363 FREMONT ST STE 308A
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3391
Practice Address - Country:US
Practice Address - Phone:269-245-8310
Practice Address - Fax:269-245-8345
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
MI5601005593363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant