Individual
MR. FREDERICK W SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
400 HOSPITAL RD, STARKVILLE, MS 39759-2163
(662) 615-2503
(662) 615-2554
Mailing address
400 HOSPITAL RD, STARKVILLE, MS 39759-2163
(662) 615-2503
(662) 615-2554
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R547514
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016840
—
MS
Enumeration date
02/08/2006
Last updated
06/27/2008
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