Provider Demographics
NPI:1366721813
Name:SMITH MARTIN, JANA DAWN (AUD)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:DAWN
Last Name:SMITH MARTIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:DAWN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 N GREEN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2807
Mailing Address - Country:US
Mailing Address - Phone:479-587-0088
Mailing Address - Fax:
Practice Address - Street 1:2100 N GREEN ACRES RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2807
Practice Address - Country:US
Practice Address - Phone:479-587-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA346231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist