Organization
E. CLYDE SMOOT, M.D.-LLC
Active
Other names
LAKE CHARLES PLASTIC SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
ERNEST CLYDE SMOOT M.D. (OWNER)
(337) 478-5577
Entity
Organization
Contact information
Practice address
4150 NELSON RD, BLDG A STE 2, LAKE CHARLES, LA 70605-4148
(337) 478-5577
(337) 478-5588
Mailing address
4150 NELSON RD, BLDG A STE 2, LAKE CHARLES, LA 70605-4148
(337) 478-5577
(337) 478-5588
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD12854R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1978671
—
LA
Enumeration date
10/30/2007
Last updated
10/01/2008
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