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Organization
SMH PROFESSIONAL SERV AT SMH
Active
Organization
SMH PROFESSIONAL SERV AT SMH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL DAVIS (CFO)
(985) 649-8866
Entity
Organization
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(985) 643-2200
Mailing address
120 INNWOOD DR, COVINGTON, LA 70433-9123
(985) 892-3225
(985) 234-0628
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Enumeration date
05/30/2005
Last updated
09/21/2009
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