Prentiss Lee Smith Sr., MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

06251 Issued in MS

Practice address

108 Lance Alworth Dr
Brookhaven, MS 39601-2300

Phone

(601) 833-8511

Fax

(601) 835-5413

NPI assigned

Oct 25, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Associated Radiologists PA

  • Diagnostic Radiology Physician
  • Brookhaven, MS
  • NPI 1790774263
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164412722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 764",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396020764",
            "telephone_number": "601-833-8511",
            "fax_number": "601-835-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 LANCE ALWORTH DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012300",
            "telephone_number": "601-833-8511",
            "fax_number": "601-835-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PRENTISS",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "06251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016651",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kia C Smith, M.REL, PCMHT
• Lesleye L Smith, CCC-A
• Manerva Angelica Smith
• Mark P Smith, OD
• Melanie Smith
• Kelli Snider
• South Mississippi Home Health Inc - Region II (Deaconess HomeCare)
• South Mississippi Home Health, Inc. (Deaconess Hospice)
• South Mississippi Wound Management LLC (South Mississippi Wound Management)
• Southern Bone & Joint Specialists

• Diagnostic Radiology Physician in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Diagnostic Radiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.