Organization
EDDIE SMITH MD A PROF MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHAEL ANGERON (OFFICE MANAGER)
(985) 325-6226
Entity
Organization
Contact information
Practice address
103 PICCIOLA PKWY, CUT OFF, LA 70345-3572
(985) 325-6226
Mailing address
103 PICCIOLA PKWY, CUT OFF, LA 70345-3572
(985) 325-6226
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1357464
—
LA
Enumeration date
08/13/2014
Last updated
01/21/2016
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