Center of Infectious Disease Excellence LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

05323 Issued in MS

Legal business name

CENTER OF INFECTIOUS DISEASE EXCELLENCE LLC

Practice address

1040 River Oaks Dr
Flowood, MS 39232-9530

Phone

(601) 944-1717

NPI assigned

May 20, 2008

Last updated

Oct 30, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David L Smith

Title

Owner

Phone

(601) 944-1717

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225324800000",
    "number": "1114184926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22679",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392252679",
            "telephone_number": "601-944-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329530",
            "telephone_number": "601-944-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER OF INFECTIOUS DISEASE EXCELLENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-10-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-944-1717"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MS",
            "license": "05323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05680536",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Flowood, MS
• Providers in Flowood, MS by specialty
• Infectious Disease Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.