Individual
DR. MARK ALAN SMOTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
239 BOWLING GREEN RD, LEXINGTON, MS 39095-5167
(662) 834-1321
(662) 834-5240
Mailing address
239 BOWLING GREEN RD, LEXINGTON, MS 39095-5167
(662) 834-1321
(662) 834-5240
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17006
OK
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
16296
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0122914
—
MS
01
—
930115308
RAILROAD MEDICARE PTAN
MS
Enumeration date
03/09/2007
Last updated
09/15/2022
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