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NPI Code Detail

MEDICARE: GEORGE J SMITH MD

MEDICARE: GEORGE J SMITH MD
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
1207RC0000XCardiovascular Disease PhysicianMD018929TN
2207RC0000XCardiovascular Disease PhysicianMD.201339LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104829837
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE J SMITH MD
Provider Business Mailing Address
First Line : 428 CLAYMONT CT
Second Line :
City : MADISONVILLE
State : LA
Zip : 70447-3432
Country : US
Telephone Number : 504-441-8732
Fax Number :
Provider Business Practice Location Address
First Line : 428 CLAYMONT CT
Second Line :
City : MADISONVILLE
State : LA
Zip : 70447-3432
Country : US
Telephone Number : 504-441-8732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 03/03/2014

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