Organization
LAKESIDE MEDICAL WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE E SMITH MD (OWNER)
(337) 527-9529
Entity
Organization
Contact information
Practice address
110 E DARBONNE ST STE B, SULPHUR, LA 70663-4958
(337) 527-9529
(337) 527-5049
Mailing address
110 E DARBONNE ST STE B, SULPHUR, LA 70663-4958
(337) 527-9529
(337) 527-5049
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
LA
Other
Enumeration date
01/16/2008
Last updated
07/21/2022
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