Individual
DR. RAY DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1453 E BERT KOUN LOOP STE 112, SHREVEPORT, LA 71105-6810
(318) 798-9400
Mailing address
PO BOX 51008, SHREVEPORT, LA 71135-1008
(318) 798-9400
(318) 798-3894
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD.022377
LA
207RI0011X
Interventional Cardiology Physician
Primary
MD.022377
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075359201
—
TX
05
—
1495689
—
LA
05
—
165720001
—
AR
01
—
P00168894
RAILROAD MEDICARE
LA
Enumeration date
11/30/2005
Last updated
08/12/2022
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