Individual
JOHN K SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13102 WADESBORO RD, PONCHATOULA, LA 70454-7114
(404) 877-2028
Mailing address
13102 WADESBORO RD, PONCHATOULA, LA 70454-7114
(404) 877-2028
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.12104R
LA
Other
Enumeration date
08/26/2006
Last updated
12/08/2020
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