Individual
BRENTON WALTER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
771 BAYOU PINES EAST DR, LAKE CHARLES, LA 70601-7183
(337) 433-1212
(337) 433-0736
Mailing address
771 BAYOU PINES EAST DR, LAKE CHARLES, LA 70601-7183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
344950
LA
207Q00000X
Family Medicine Physician
66657
MN
Other
Enumeration date
06/01/2018
Last updated
06/25/2025
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