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Mr. Prentiss Lee Smith SR., MD
Diagnostic Radiology Physician in Brookhaven, Mississippi
NPI 1164412722

Prentiss Lee Smith SR. is a Diagnostic Radiology Physician based in Brookhaven, MS and is specialized in Diagnostic Radiology. Prentiss Lee Smith SR. practices in Brookhaven, MS and has the professional credentials of MD. The NPI Number for Prentiss Lee Smith SR. is 1164412722 and holds a License No. 06251 (Mississippi).

The current practice location address for Prentiss Lee Smith SR. is 108 Lance Alworth Dr, Brookhaven, MS and can be reached out via phone at 601-833-8511 and via fax at 601-835-5413. You can also correspond with Prentiss Lee Smith SR. through the mailing address at PO BOX 764, BROOKHAVEN, MS - 39602-0764 (mailing address contact number: 601-833-8511).

Location: 108 Lance Alworth Dr, Brookhaven, MS, 39602-0764
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164412722
Provider Name
Prentiss Lee Smith SR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
108 Lance Alworth Dr, Brookhaven, MS, 39602-0764
Phone Number
601-833-8511
Fax Number
601-835-5413
Provider Enumeration Date
10/25/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0016651 05 MS
institution
Provider Business Practice Location Address Details
Address
108 Lance Alworth Dr
City
Brookhaven
State
Mississippi
Zip
39601-2300
Phone Number
601-833-8511
Fax Number
601-835-5413
person
Provider Business Mailing Address Details
Address
108 Lance Alworth Dr
City
Brookhaven
State
Mississippi
Zip
39601-2300
Phone Number
601-833-8511
Fax Number
601-835-5413
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
06251 (Mississippi)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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