Individual
CAROLYN YVONNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
850 N PIERCE ST, STE C, LAFAYETTE, LA 70501
(337) 289-5668
(337) 289-5670
Mailing address
PO BOX 90092, LAFAYETTE, LA 70509-0092
(337) 289-5668
(337) 289-5670
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
11945R
LA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
11945R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1683809
—
LA
01
—
3754206001
FIRST HEALTH WC
—
01
—
990014210
RAILROAD MEDICARE
—
Enumeration date
02/02/2006
Last updated
12/15/2009
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