Provider Demographics
NPI:1851787469
Name:SMITH, PHILLIP AUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:AUSTIN
Last Name:SMITH
Suffix:
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 1:8401 PICARDY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3685
Mailing Address - Country:US
Mailing Address - Phone:225-308-0247
Mailing Address - Fax:225-308-0249
Practice Address - Street 1:8401 PICARDY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3685
Practice Address - Country:US
Practice Address - Phone:225-308-0247
Practice Address - Fax:225-308-0249
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL35351207RC0000X, 207RI0011X
LA336202207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology