Individual
JONATHAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
601 BROOKMAN DR EXT, BROOKHAVEN, MS 39601-2371
(601) 823-5275
Mailing address
427 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2350
(601) 833-6011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
904849
MS
Other
Enumeration date
09/09/2021
Last updated
06/12/2023
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