Provider Demographics
NPI:1578508735
Name:SMITH, ADRIAN R (MD)
Entity Type:Individual
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First Name:ADRIAN
Middle Name:R
Last Name:SMITH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 FLOWOOD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9303
Mailing Address - Country:US
Mailing Address - Phone:601-939-9999
Mailing Address - Fax:601-939-0590
Practice Address - Street 1:2550 FLOWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9303
Practice Address - Country:US
Practice Address - Phone:601-939-9999
Practice Address - Fax:601-939-0590
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2013-08-26
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Provider Licenses
StateLicense IDTaxonomies
MS17013208200000X, 2082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery