Individual
JAIRUS JAMES MATTHEW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
4097 RYAN ST, LAKE CHARLES, LA 70605-2819
(337) 474-0434
Mailing address
2845 COUNTRY CLUB RD APT 1315, LAKE CHARLES, LA 70605-6050
(337) 578-8786
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.023262
LA
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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