Individual
THOMAS BENNETT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5570
Mailing address
106 COLES WAY, MADISON, MS 39110-6880
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
T-2603
MS
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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