Individual
GORDON E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
117 BO BO DR, CRYSTAL SPRINGS, MS 39059-2741
(601) 892-6330
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1039
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08276334
—
MS
05
—
1431281
—
LA
Enumeration date
01/08/2007
Last updated
10/06/2025
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