Individual
MALCOLM C SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-4947
Mailing address
400 VETERANS AVE, BILOXI, MS 39531-2410
(228) 523-4947
(228) 523-5979
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
903210
MS
363LG0600X
Gerontology Nurse Practitioner
903210
MS
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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