Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD.012364 | LA |
N | 207RP1001X | Pulmonary Disease | 12364 | LA |
NPI | 1356310650 |
---|---|
Provider Name | Kenneth B Smith |
First Address | Metairie, LA 70006-2970 |
Second Address | Metairie, LA 70006-2970 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 19/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1192554 | (05) | LA |
B61244 | (02) | LA |