Provider Demographics
NPI:1700489507
Name:SMITH, DAVID BARTON (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BARTON
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BRAMLETT BLVD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-4129
Mailing Address - Country:US
Mailing Address - Phone:662-234-7221
Mailing Address - Fax:662-234-7286
Practice Address - Street 1:501 BRAMLETT BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4129
Practice Address - Country:US
Practice Address - Phone:662-234-7221
Practice Address - Fax:662-234-7286
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-15607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist