Individual
TYLER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 HIGHWAY 49 S, SUITE 2, RICHLAND, MS 39218-9425
(769) 233-8844
(769) 251-1825
Mailing address
1201 HIGHWAY 49 S, SUITE 2, RICHLAND, MS 39218-9425
(769) 233-8844
(769) 251-1825
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT2992
MS
Other
Enumeration date
02/04/2015
Last updated
09/21/2015
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