Individual
MR. JEREMY K SMALLWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA/RA, RT(R)(VI)
Contact information
Practice address
3109 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4361
(228) 818-1117
(228) 818-6090
Mailing address
3109 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4361
(228) 818-1117
(228) 818-6090
Taxonomy
Speciality
Code
Description
License number
State
243U00000X
Radiology Practitioner Assistant
Primary
—
MS
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
—
MS
Other
Enumeration date
05/28/2009
Last updated
05/28/2009
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