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General NPI Number Information
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NPI Number | 1750250577
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Entity Type | Organization
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Legal Business Name | SOUTHERN INTERVENTIONAL PAIN SPECIALISTS JACKSON, PLLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1 LAYFAIR DR STE 400
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City | FLOWOOD
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State | MS
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Zip | 39232-9717
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Country | US
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Telephone | 601-720-0205
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Fax | 601-720-0205
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Provider Business Mailing Address
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Address Line | 133 CALUMET DR
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City | MADISON
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State | MS
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Zip | 39110-9298
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Country | US
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Telephone | 601-720-0205
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEREMY SMITHERMAN
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Credential | MD
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Telephone | 601-720-0205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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