person
Lisa Mabry Smith, MD
Diagnostic Radiology Physician in Gulfport, Mississippi
NPI 1912298498

Lisa Mabry Smith is a Diagnostic Radiology Physician based in Gulfport, MS and is specialized in Diagnostic Radiology. Lisa Mabry Smith practices in Gulfport, MS and has the professional credentials of MD. The NPI Number for Lisa Mabry Smith is 1912298498 and holds a License No. 32125 (Mississippi).

The current practice location address for Lisa Mabry Smith is 14257 Dedeaux Rd, Gulfport, MS and can be reached out via phone at 228-314-7226 and via fax at 228-314-7227. You can also correspond with Lisa Mabry Smith through the mailing address at PO BOX 10370, GULFPORT, MS - 39505-0370 (mailing address contact number: 228-314-7226).

Location: 14257 Dedeaux Rd, Gulfport, MS, 39505-0370
person
Provider Profile Details
NPI Number
1912298498
Provider Name
Lisa Mabry Smith
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
14257 Dedeaux Rd, Gulfport, MS, 39505-0370
Phone Number
228-314-7226
Fax Number
228-314-7227
Provider Enumeration Date
05/02/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00536826 05 MS
568617YSJ9 01 MS MEDICARE
598607 01 MS BCBS MS
P01842090 01 MS RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
14257 Dedeaux Rd
City
State
Zip
39503-3369
Phone Number
228-314-7226
Fax Number
228-314-7227
person
Provider Business Mailing Address Details
Address
Po Box 10370
City
State
Zip
39505-0370
Phone Number
228-314-7226
Fax Number
228-314-7227
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
()
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
32125 (Alabama)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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