Individual
DR. KIMBERLY MCCULLOUGH SMASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2675 RIVER RIDGE DR, JACKSON, MS 39216
(601) 718-0308
(855) 838-7032
Mailing address
PO BOX 1020, JACKSON, MS 39215-1020
(601) 718-0308
(855) 838-7032
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21233
MS
207Q00000X
Family Medicine Physician
4301090322
MI
Other
Enumeration date
07/04/2007
Last updated
06/22/2018
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