Individual
JASMINE MARTIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
105 LEXINGTON DR, H, MADISON, MS 39110-6645
(601) 910-7300
Mailing address
105 LEXINGTON DR, STE H, MADISON, MS 39110-6646
(601) 910-7300
(601) 910-7071
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT4561
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00209229
—
MS
Enumeration date
04/15/2011
Last updated
11/06/2017
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