Individual
DR. DEREL J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.D.
Contact information
Practice address
12125 HIGHWAY 90, LULING, LA 70070-3000
(985) 785-8772
(985) 785-8772
Mailing address
143 BAYOU EST S, DES ALLEMANDS, LA 70030-3342
(985) 758-2021
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14651
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1266884
—
LA
Enumeration date
09/12/2006
Last updated
07/08/2007
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