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Individual

DR. KATHY JO SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
7301 THEODORE DAWES RD, THEODORE, AL 36582-4029
(251) 653-9831
(251) 653-5477
Mailing address
2105 CHARINGWOOD DR W, MOBILE, AL 36695-2916
(251) 510-6810
(251) 653-5477

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17183
AL
183500000X
Pharmacist
E-12626
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17183
STATE LICENSE
AL
01
E-12626
STATE LICENSE
MS
Enumeration date
06/01/2013
Last updated
06/18/2014
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