Provider Demographics
NPI:1790783322
Name:SMITH, LANDON CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:LANDON
Middle Name:CRAIG
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:411 E VAUGHN AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-5972
Mailing Address - Country:US
Mailing Address - Phone:318-255-9414
Mailing Address - Fax:318-255-9434
Practice Address - Street 1:411 E VAUGHN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-5972
Practice Address - Country:US
Practice Address - Phone:318-255-9414
Practice Address - Fax:318-255-9434
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2008-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA200383207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology