Provider Demographics
NPI:1497998835
Name:SMITH, KATHERINE ELISE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ELISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1006 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4103
Mailing Address - Country:US
Mailing Address - Phone:318-222-6226
Mailing Address - Fax:318-222-6227
Practice Address - Street 1:1006 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4103
Practice Address - Country:US
Practice Address - Phone:318-222-6226
Practice Address - Fax:318-222-6227
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2042282084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry