Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 05323 | MS |
NPI | 1023045572 |
---|---|
Provider Name | Dr. David L. Smith |
First Address | Flowood, MS 39232-9576 |
Second Address | Flowood, MS 39232-9576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 19/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0125737 | (05) | MS |
C51293 | (02) | MS |