Individual
ETHEL STACKHOUSE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
125 KAROLWOOD DR, LAFAYETTE, LA 70503
(337) 984-1924
(337) 981-0492
Mailing address
125 KAROLWOOD DR, LAFAYETTE, LA 70503
(337) 984-1924
(337) 981-0492
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LA9038
LA
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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