Individual
GARY L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
971 LAKELAND DR, SUITE 202, JACKSON, MS 39216-4643
(601) 362-1990
(601) 362-1988
Mailing address
971 LAKELAND DR, SUITE 202, JACKSON, MS 39216-4643
(601) 362-1990
(601) 362-1988
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12539
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00111828
—
MS
Enumeration date
06/13/2006
Last updated
07/08/2007
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