Individual
DR. ERNEST CLYDE SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
12854R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1978671
—
LA
Enumeration date
01/26/2006
Last updated
09/27/2011
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