Provider Demographics
NPI:1689914921
Name:MCGEHEE, RACHAEL TYLER SMOOT (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:TYLER SMOOT
Last Name:MCGEHEE
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:DR
Other - First Name:RACHAEL
Other - Middle Name:TYLER
Other - Last Name:SMOOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MD
Mailing Address - Street 1:2937 VETERANS MEMORIAL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6067
Mailing Address - Country:US
Mailing Address - Phone:504-208-3647
Mailing Address - Fax:
Practice Address - Street 1:4850 N 9TH AVE STE 4
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2406
Practice Address - Country:US
Practice Address - Phone:850-477-1125
Practice Address - Fax:850-479-5809
Is Sole Proprietor?:No
Enumeration Date:2013-02-24
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA71621223S0112X
FLDN240391223S0112X
CODEN.002044201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery