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Individual

CHARLES BARRETT SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(800) 841-4236
Mailing address
PO BOX 60962, NEW ORLEANS, LA 70160-0962
(800) 841-4236

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
207735
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02208350
MS
05
1883484
LA
Enumeration date
03/20/2009
Last updated
02/01/2016
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