MEDICARE: BARBARA EASTERLING SMITH MD

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	207Q00000X	Family Medicine Physician	12484	MS

General Provider Information

NPI Number	:	1730187261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA EASTERLING SMITH MD

Provider Business Mailing Address
First Line	:	PO BOX 321359
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-1359
Country	:	US
Telephone Number	:	601-936-1395
Fax Number	:	601-933-6596

Provider Business Practice Location Address
First Line	:	150 JEFFERSON DAVIS BLVD STE 130
Second Line	:
City	:	NATCHEZ
State	:	MS
Zip	:	39120
Country	:	US
Telephone Number	:	601-445-1715
Fax Number	:	601-445-6720

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	08/12/2019

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