MEDICARE: JAMES ALBERTO SMITH L.AC.

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
1	171100000X	Acupuncturist	ACA200038	LA
2	171100000X	Acupuncturist	AC156785	OR

General Provider Information

NPI Number	:	1740540228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ALBERTO SMITH L.AC.

Provider Business Mailing Address
First Line	:	PO BOX 792413
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70179-2413
Country	:	US
Telephone Number	:	504-858-1295
Fax Number	:	504-264-5489

Provider Business Practice Location Address
First Line	:	4322 CANAL ST
Second Line	:	SUITE 5
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-5945
Country	:	US
Telephone Number	:	504-858-1295
Fax Number	:	504-264-5489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2012
Last Update Date	:	05/18/2012

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