Individual
MR. ALLAN TICSAY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2050 N MALL DR, ALEXANDRIA, LA 71301-3619
(318) 445-4308
(318) 445-0275
Mailing address
113 NORTH VIEW DR, PINEVILLE, LA 71360
(260) 387-9281
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
26021014A
IN
1835P2201X
Ambulatory Care Pharmacist
Primary
PST.021571
LA
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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