Individual
MR. JOHNNY LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 364-1222
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 364-1222
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RCP1286
MS
2279C0205X
Critical Care Registered Respiratory Therapist
RCP1286
MS
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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