Amy Ann Smith, PA-C
Physician Assistant in Decatur, IL. Individual provider (NPI-1).
NPI number1174875223
StatusActive
Last updated in NPPESJan 13, 2023
Details
- NPI
- 1174875223
- Entity type
- Individual (NPI-1)
- Name
- Ms. Amy Ann Smith
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 12, 2012
- Certification date
- Jan 13, 2023
- Last updated
- Jan 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085005048 | IL | Yes |
| 363AM0700X | Physician Assistant, Medical | 085005048 | IL | |
| 363AM0700X | Physician Assistant, Medical | 5214 | AZ |
Other names
- Amy Ann Davis (Former Name)
Practice location
550 Southland DrDecatur, IL 62521-4080
Phone 217-425-9264 · Fax 217-425-5983
Mailing address
2300 N Edward StGsbll
Decatur, IL 62526-4163
Phone 217-876-2857 · Fax 217-876-2874
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All 35 Physician Assistant providers in Decatur · All 1,941 providers in Decatur
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