Individual
PAUL R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
13734R
LA
2085R0202X
Diagnostic Radiology Physician
Primary
13734R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1429864
—
LA
01
—
300113464
RAILROAD MEDICARE
LA
Enumeration date
07/11/2005
Last updated
03/21/2018
Update your record
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