Individual
NICHOLAS JOHN GRAYSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
4028 ROBIN DR, JACKSON, MS 39206-5845
(615) 489-3384
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
T-5136
MS
Other
Enumeration date
03/24/2023
Last updated
07/04/2023
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