LISA MABRY SMITH

GULFPORT, MS
NPI1912298498
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: MS  24862)
Additional Taxonomies2085B0100X Radiology, Body Imaging
(Licence: FL  ME164947)
2085R0202X Radiology, Diagnostic Radiology
(Licence: FL  ME164947)
2085R0202X Radiology, Diagnostic Radiology
(Licence: AL  32125)
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2011-05-02
Last Update Date2025-09-09
Business Address
-- LISA MABRY SMITH MD
14257 DEDEAUX RD
GULFPORT, MS 39503-3369
Phone number: 228-314-7226
Mailing Address
-- LISA MABRY SMITH MD
PO BOX 10370
GULFPORT, MS 39505-0370
Phone number: 228-314-7226