Provider Demographics
NPI:1821390188
Name:SMITH, DEVIN EUGENE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DEVIN
Middle Name:EUGENE
Last Name:SMITH
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:2660 N SUSQUEHANNA TRL
Practice Address - Street 2:
Practice Address - City:SHAMOKIN DAM
Practice Address - State:PA
Practice Address - Zip Code:17876-9105
Practice Address - Country:US
Practice Address - Phone:570-884-3726
Practice Address - Fax:570-884-3728
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2020-08-10
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Provider Licenses
StateLicense IDTaxonomies
PAMA054706363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant