Individual
DR. DANTWAN SHAWNTEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
270 AUGUST DR, BRANDON, MS 39042-8473
(662) 251-9129
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
T-3672
MS
207RC0000X
Cardiovascular Disease Physician
Primary
T-3672
MS
Other
Enumeration date
06/29/2018
Last updated
06/28/2021
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