Douglas Leroy Smith III, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

E-14427 Issued in MS

Practice address

1015 Lee Dr Ste 11
Clarksdale, MS 38614-3619

Phone

(662) 627-7857

Fax

(662) 627-7225

NPI assigned

Jan 12, 2021

Sex

Male

Sole proprietor

Yes

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 Pharmacy

State licenses

Practice roles

Locations

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

• Westgate Drugs Inc

  • Community/Retail Pharmacy
  • Clarksdale, MS
  • NPI 1477618809
  NPD

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1770172090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 LEE DR STE 11",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386143619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 LEE DR STE 11",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386143619",
            "telephone_number": "662-627-7857",
            "fax_number": "662-627-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "DOUGLAS",
        "middle_name": "LEROY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-14427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00035351",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph K Shleweet, D.D.S.
• Cherrelle N Shorter, LCSW
• Cheryl Sias-Micou, MSW
• Benita Carlene Simmons, M.A.
• Taisha Simmons, M.ED.
• Jayson Phillips Smith, PT
• Marian Smith, FNP
• Quinton Smith, M.ED.
• Sherrica Sherrell Smith, FNP-C, PMHNP-BC
• Val Soldevila, RPH, CFO

• Pharmacist in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.