Individual
THOMAS BRENT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2510 LAKELAND DR, FLOWOOD, MS 39232-9513
(601) 355-1234
(601) 718-2778
Mailing address
2510 LAKELAND DR, FLOWOOD, MS 39232-9513
(601) 355-1234
(601) 326-3566
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R851007
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08828791
—
MS
Enumeration date
09/08/2006
Last updated
04/16/2020
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