Provider Demographics
NPI:1386833424
Name:DR. KAREN SMITHS OFFICE LLC
Entity Type:Organization
Organization Name:DR. KAREN SMITHS OFFICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-233-3731
Mailing Address - Street 1:601 W SAINT MARY BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3568
Mailing Address - Country:US
Mailing Address - Phone:337-233-3731
Mailing Address - Fax:
Practice Address - Street 1:601 W SAINT MARY BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3568
Practice Address - Country:US
Practice Address - Phone:337-233-3731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13387R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CN15Medicare PIN