Organization
MELISSA W. SMITH, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA WELCH SMITH MD (OWNER/PRESIDENT)
(985) 781-4848
Entity
Organization
Contact information
Practice address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Mailing address
1150 ROBERT BLVD, SUITE 360, SLIDELL, LA 70458-2004
(985) 781-4848
(985) 781-4850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
200355
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028177
—
LA
01
—
435678834
BCBS OF MS PROVIDER NUMBER
MS
01
—
4356788340
BCBS LA PROVIDER NUMBER
LA
01
—
4N209DE75
MEDICARE LINK #
LA
01
—
DN7783
RAILROAD MEDICARE
LA
Enumeration date
03/18/2008
Last updated
02/07/2011
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