Individual
FLOYD C SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 GUADALUPE ST, NEW IBERIA, LA 70563-1319
(337) 201-7028
Mailing address
123 GUADALUPE ST, NEW IBERIA, LA 70563-1319
(337) 201-7028
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
008478558
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
850721244
—
LA
Enumeration date
10/17/2022
Last updated
10/17/2022
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