Individual
TALETHA BRENTS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
MD.200356
LA
2085R0202X
Diagnostic Radiology Physician
Primary
077667
GA
2085R0202X
Diagnostic Radiology Physician
21442
MS
390200000X
Student in an Organized Health Care Education/Training Program
200356
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09432255
—
MS
05
—
1067806
—
LA
Enumeration date
08/05/2007
Last updated
05/06/2019
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