Organization
CENTER OF INFECTIOUS DISEASE EXCELLENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L SMITH (OWNER)
(601) 944-1717
Entity
Organization
Contact information
Practice address
1040 RIVER OAKS DR, FLOWOOD, MS 39232-9530
(601) 944-1717
Mailing address
PO BOX 22679, JACKSON, MS 39225-2679
(601) 944-1717
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
05323
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05680536
—
MS
Enumeration date
05/20/2008
Last updated
10/30/2008
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