Mr Prentiss Lee Smith Sr, MD is a
Radiology - Diagnostic Radiology physician based in Brookhaven, Mississippi. Mr Prentiss Lee Smith Sr is licensed to practice in Mississippi (license number 06251) and his current practice location is 108 Lance Alworth Dr, Brookhaven, Mississippi. He can be reached at his office (for appointments etc.) via phone at
(601) 833-8511.
NPI number for Mr Prentiss Lee Smith Sr is 1164412722 and his current mailing address is Po Box 764, Brookhaven, Mississippi. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164412722.
Physician's Profile
Full Name | Mr Prentiss Lee Smith Sr |
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Gender | Male |
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Speciality | Radiology - Diagnostic Radiology |
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Location | 108 Lance Alworth Dr, Brookhaven, Mississippi |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164412722
- Provider Enumeration Date: 10/25/2005
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Prentiss Lee Smith Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164412722 | NPI | - | NPPES |
0016651 | Medicaid | MS | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2085R0202X | Radiology - Diagnostic Radiology | 06251 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Prentiss Lee Smith Sr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Prentiss Lee Smith Sr, MD Po Box 764, Brookhaven, MS 39602-0764 Ph: (601) 833-8511 | Mr Prentiss Lee Smith Sr, MD 108 Lance Alworth Dr, Brookhaven, MS 39601-2300 Ph: (601) 833-8511 |
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