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NPI Code Detail

MEDICARE: MR. PAUL EUGENE SMITH CRNA

MEDICARE:  MR. PAUL EUGENE SMITH  CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistR673722MS

General Provider Information

NPI Number : 1043211642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PAUL EUGENE SMITH CRNA
Provider Business Mailing Address
First Line : 806 GRANT ST
Second Line :
City : SUMMIT
State : MS
Zip : 39666-9041
Country : US
Telephone Number : 601-276-7759
Fax Number :
Provider Business Practice Location Address
First Line : 54 SERGEANT PRENTISS DR
Second Line :
City : NATCHEZ
State : MS
Zip : 39120-4726
Country : US
Telephone Number : 601-443-2100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2005
Last Update Date : 07/08/2007

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Directions to “ MR. PAUL EUGENE SMITH CRNA” Practice Location

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