Organization
ANDREA L. SMITH MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA L SMITH M.D. (OWNER)
(662) 624-5485
Entity
Organization
Contact information
Practice address
785 OHIO AVE, SUITE 1D, CLARKSDALE, MS 38614-6217
(662) 624-5485
(662) 624-8890
Mailing address
785 OHIO AVE, SUITE 1D, CLARKSDALE, MS 38614-6217
(662) 624-5485
(662) 624-8890
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
09185
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05512228
—
MS
Enumeration date
03/14/2009
Last updated
05/01/2009
Update your record
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