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NPI Code Detail

MEDICARE: NANCY V SMITH M.D.

MEDICARE: NANCY V SMITH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician014604LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073514782
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY V SMITH M.D.
Provider Business Mailing Address
First Line : 109 CIRCLE DR
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-5303
Country : US
Telephone Number : 318-323-1834
Fax Number : 318-323-0376
Provider Business Practice Location Address
First Line : 109 CIRCLE DR
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-5303
Country : US
Telephone Number : 318-323-1834
Fax Number : 318-323-0376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 12/14/2012

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