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Organization

DEPARTMENT OF VETERANS AFFAIRS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURIE SMITH R.D. C.N.S.D. (CLINICAL DIETITIAN)
(601) 362-4471
Entity
Organization

Contact information

Practice address
1500 EAST WOODROW WILSON DRIVE, JACKSON, MS 39216-5199
(601) 362-4471
(601) 368-4483
Mailing address
1500 EAST WOODROW WILSON DRIVE, JACKSON, MS 39216-5199
(601) 362-4471
(601) 368-4483

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
R422643

Other

Enumeration date
10/04/2006
Last updated
08/08/2008
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