Individual
KIRK WAYNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2810 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5906
(800) 893-9698
Mailing address
200 CORPORATE BLVD, STE 201, LAFAYETTE, LA 70508-3870
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
017346
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1338168
—
LA
Enumeration date
09/25/2006
Last updated
07/08/2007
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