MEDICARE: GORDON E SMITH LPT

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
1	225100000X	Physical Therapist	PT1039	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396893160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORDON E SMITH LPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 BO BO DR
Second Line	:
City	:	CRYSTAL SPRINGS
State	:	MS
Zip	:	39059-2741
Country	:	US
Telephone Number	:	601-892-6330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	10/06/2025

Similar Medicare Providers

1710849518 — MADELINE CARTER
Practice Location Address:

113 BO BO DR
CRYSTAL SPRINGS, MS
39059-2741

Practice Phone: 601-892-4121
Practice Fax:

1205802980 — CITY DRUGS OF CRYSTAL SPRINGS, INC.
Practice Location Address:

113 BO BO DR
CRYSTAL SPRINGS, MS
39059-2741

Practice Phone: 601-892-4121
Practice Fax: 601-892-1598

1154571958 — CYNTHIA TRONSTAD PT
Practice Location Address:

117 BO BO DR
CRYSTAL SPRINGS, MS
39059-2741

Practice Phone: 601-892-6330
Practice Fax: 601-892-6331

1477705929 — SHIRLEY D MONCURE
Practice Location Address:

117 BO BO DR
CRYSTAL SPRINGS, MS
39059-2741

Practice Phone: 601-892-6330
Practice Fax:

1801333521 — DRAYER PHYSICAL THERAPY MISSISSIPPI LLC
Practice Location Address:

117 BO BO DRIVE
CRYSTAL SPRINGS, MS
39059-2741

Practice Phone: 601-892-6330
Practice Fax: 601-892-6331

1225504269 — CITY DRUG, LLC
Practice Location Address:

113 BO BO DR
CRYSTAL SPRINGS, MS
39059-2741

Practice Phone: 601-892-4121
Practice Fax: 601-892-1598

Directions to “ GORDON E SMITH LPT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.