Individual
DR. RUSSEL N SMITH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5900 COLISEUM BLVD, ALEXANDRIA, LA 71303-3714
(318) 386-8110
Mailing address
201 SUNRISE RD, JONESVILLE, LA 71343-5308
(318) 758-1469
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59098491205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D6204
—
UT
Enumeration date
03/30/2006
Last updated
10/21/2020
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