LISA MABRY SMITH MD NPI 1912298498

NPI Information

NPI: 1912298498
Provider Name: LISA MABRY SMITH, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Organization: USA HEALTH PHYSICIAN BILLING SERVICES LLC

PECOS Registration: Yes

Address:
14257 DEDEAUX RD
GULFPORT, MS
ZIP 39503
Phone: (228) 314-7226
Get Directions

Lisa Mabry Smith, MD is a diagnostic radiology radiology in Gulfport, MS with 13 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Lisa Mabry Smith, MD NPI is 1912298498. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:2011

The provider's business location address is:

14257 DEDEAUX RD
GULFPORT, MS
ZIP 39503-369
Phone: (228) 314-7226
Fax: (228) 314-7227

The NPI 1912298498 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/2/2011 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	32125	ALABAMA	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	2085R0202X	Radiology	Diagnostic Radiology	24862	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P01842090	OTHER	MISSISSIPPI	RAILROAD MEDICARE
2	598607	OTHER	MISSISSIPPI	BCBS MS
3	00536826	MEDICAID	MISSISSIPPI
4	568617YSJ9	OTHER	MISSISSIPPI	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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