Individual
MR. PATRICK O SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.H.D.
Contact information
Practice address
878 LAKELAND DR, JACKSON, MS 39216-4644
(601) 984-6800
(601) 984-6812
Mailing address
PO BOX 4999, JACKSON, MS 39296-4999
(601) 984-5410
(601) 815-3771
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32-480
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03537326
—
MS
Enumeration date
10/10/2006
Last updated
02/13/2014
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