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David L. Smith

Internal Medicine

Allopathic & Osteopathic Physicians

1040 River Oaks Dr Ste 303, Flowood, MS 39232-9576

PECOS Enrollment

This provider is enrolled in PECOS as DAVID SMITH.

Based on the most recent information from CMS, provider David L. Smith is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1023045572
Provider Type
Individual
Full Name
Smith, David L.
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/27/2006
Last Updated
8/19/2020

Contact Information

Practice Location

1040 River Oaks Dr Ste 303, Flowood, MS 39232-9576

(601) 936-0706

(601) 936-6150

Mailing Location

1040 River Oaks Dr Ste 303, Flowood, MS 39232-9576

(601) 936-0706

(601) 936-6150

Provider Taxonomies

Code	Description	License
Code 207RI0200X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 05323 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 0125737	Description Medicaid	Issuer Unlisted Mississippi

David L. Smith

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Flowood River Oaks Hma Medical Group, Llc

Center Of Infectious Disease Excellence Llc

Nancy Dorman Md,Phd Pllc

Center Of Infectious Disease Excellence