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NPI Code Detail

MEDICARE: BAYOU PATHOLOGY, APMC & N. SMITH, MD, LLP

MEDICARE: BAYOU PATHOLOGY, APMC & N. SMITH, MD, LLP
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 PhysicianLA

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 : 1396746855
Entity Type Code : Organization
Provider Name (Legal Business Name) : BAYOU PATHOLOGY, APMC & N. SMITH, MD, LLP
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 : 401 E VAUGHN AVE
Second Line :
City : RUSTON
State : LA
Zip : 71270-5950
Country : US
Telephone Number : 318-323-1834
Fax Number : 318-323-0376
Authorized Official
Title or Position : PRACTICE MANAGER
Name : MS. SANDRA C HARRISON
Credential :
Telephone Number : 318-323-1834
Provider Enumeration Date : 08/09/2005
Last Update Date : 05/20/2008

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