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Individual

BOBBY SMITH II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
921 WEST BEACON STREET, PHILADELPHIA, MS 39350
(601) 656-6116
(601) 656-5445
Mailing address
921 WEST BEACON STREET, PHILADELPHIA, MS 39350
(601) 656-6116
(601) 656-5445

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16026
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00119762
MS
Enumeration date
04/26/2006
Last updated
01/22/2008
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