Mr Johnathon Crawford Smith Sr, CLPN is a
Licensed Practical Nurse based in Mantachie, Mississippi. Mr Johnathon Crawford Smith Sr is licensed to practice in Mississippi (license number P231371) and his current practice location is
165 Bankhead Rd Sw, Mantachie, Mississippi. He can be reached at his office (for appointments etc.) via phone at
(662) 840-1944.
NPI number for Mr Johnathon Crawford Smith Sr is 1275718660 and his current mailing address is 165 Bankhead Road, Mantachie, Mississippi. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1275718660.
Provider's Profile
| Full Name | Mr Johnathon Crawford Smith Sr |
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| Gender | Male |
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| Speciality | Licensed Practical Nurse |
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| Location | 165 Bankhead Rd Sw, Mantachie, Mississippi |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1275718660
- Provider Enumeration Date: 01/03/2008
- Last Update Date: 01/03/2008
Medical Identifiers
Medical identifiers for Mr Johnathon Crawford Smith Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1275718660 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 164W00000X | Licensed Practical Nurse | P231371 (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 Johnathon Crawford 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 Johnathon Crawford Smith Sr, CLPN
165 Bankhead Road,
Mantachie, MS 38855-7265
Ph: (662) 840-1944 | Mr Johnathon Crawford Smith Sr, CLPN
165 Bankhead Rd Sw,
Mantachie, MS 38855-7267
Ph: (662) 840-1944 |
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