Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 4512 | LA |
Y | 213EG0000X | General Practice | 4512 | LA |
NPI | 1003297912 |
---|---|
Provider Name | Dr. Chet Smith |
First Address | New Orleans, LA 70119-2715 |
Second Address | New Orleans, LA 70119-2715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 16/06/2015 |