Provider Demographics
NPI:1023007812
Name:SMITH, JAMES GARLAND JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GARLAND
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:318-966-4541
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:9820 BAYOU BEND DR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-8599
Practice Address - Country:US
Practice Address - Phone:318-797-6627
Practice Address - Fax:318-797-9395
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018986207R00000X, 207RC0200X, 207RP1001X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1926973Medicaid
LAF21761Medicare UPIN
LA5N916Medicare ID - Type UnspecifiedMEDICARE NUMBER