| Andrea L. Smith Md | |
|
785 Ohio Ave Suite 1d Clarksdale MS 38614-6217 | |
| (662) 624-5485 | |
| (662) 624-8890 |
| Full Name | Andrea L. Smith Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 785 Ohio Ave, Clarksdale, Mississippi |
| Authorized Official Name and Position | Andrea L Smith (OWNER) |
| Authorized Official Contact | 6626245485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea L. Smith Md 785 Ohio Ave Suite 1d Clarksdale MS 38614-6217 Ph: (662) 624-5485 | Andrea L. Smith Md 785 Ohio Ave Suite 1d Clarksdale MS 38614-6217 Ph: (662) 624-5485 |
| NPI Number | 1679714091 |
|---|---|
| Provider Enumeration Date | 03/14/2009 |
| Last Update Date | 05/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679714091 | NPI | - | NPPES |
| 05512228 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 09185 (Mississippi) | Primary |
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