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Individual

BRIAN M. SMITH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
106 TRI-STATE DRIVE, SAREPTA, LA 71071
(318) 994-2266
(318) 539-9177
Mailing address
106 TRI-STATE DRIVE, SAREPTA, LA 71071
(318) 994-2266
(318) 539-9177

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26105
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1629014
LA
Enumeration date
02/13/2006
Last updated
07/08/2007
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