Individual
DR. JERRY ALTON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
902 S VIENNA ST, RUSTON, LA 71270-5830
(318) 513-1950
(318) 513-1952
Mailing address
PO BOX 2034, RUSTON, LA 71273-2034
(318) 513-1950
(318) 513-1952
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
018988
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1691542
—
LA
Enumeration date
06/05/2006
Last updated
07/31/2011
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