Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 018986 | LA |
N | 111NI0900X | Internist | 018986 | LA |
N | 207RC0200X | Critical Care Medicine | 018986 | LA |
N | 207RP1001X | Pulmonary Disease | 018986 | LA |
NPI | 1023007812 |
---|---|
Provider Name | Dr. James Garland Smith JR. |
First Address | Shreveport, LA 71115-8599 |
Second Address | Shreveport, LA 71115-8599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 13/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1926973 | (05) | LA |
F21761 | (02) | LA |