Individual
MARY KELLI SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 OCHSNER BLVD, COVINGTON, LA 70433-8107
(985) 898-7150
(985) 898-7151
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
12887
MS
207Q00000X
Family Medicine Physician
Primary
307654
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123462
—
MS
Enumeration date
05/10/2006
Last updated
05/10/2018
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