Individual
MR. MARTIC SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2105 AIRLINE DR, BOSSIER CITY, LA 71111-3105
(318) 549-2011
Mailing address
2701 LONG BRANCH LN, SHREVEPORT, LA 71118-5027
(318) 572-5474
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN082737 AP03943
LA
Other
Enumeration date
08/31/2006
Last updated
09/23/2008
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