Smith, Stephen Keith

Smith, Stephen Keith is an individual health care provider with primary practice located at 969 Lakeland Dr , Jackson MS 39216-4606. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Smith, Stephen Keith can be contacted via phone (601) 200-3100.

Contact Information

Primary practice address
969 Lakeland Dr Jackson MS 39216-4606
Fax: (601) 200-3109
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 21788 Mississippi

Profile Details

NPI number 1174707368
LBN Legal business name Smith, Stephen Keith
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 24th, 2007
Last updated Apr 29th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174707368 NPPES
Mississippi MEDICAID 09034221

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