Individual
DR. ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1134 WINTER ST, JACKSON, MS 39204-2841
(601) 948-5572
(601) 353-7070
Mailing address
1134 WINTER ST, JACKSON, MS 39204-2841
(601) 948-5572
(601) 353-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04778
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00011675
—
MS
Enumeration date
06/30/2006
Last updated
07/07/2008
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