Provider Demographics
NPI:1902848872
Name:SMITH, KIERNAN ADAMS (MD)
Entity Type:Individual
Prefix:DR
First Name:KIERNAN
Middle Name:ADAMS
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KIERNAN
Other - Middle Name:ADAMS
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1430 TULANE AVE # 8033
Mailing Address - Street 2:TULANE UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-4700
Mailing Address - Fax:504-988-4701
Practice Address - Street 1:1430 TULANE AVE # 8033
Practice Address - Street 2:TULANE UNIVERSITY SCHOOL OF MEDICINE
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-4700
Practice Address - Fax:504-988-4701
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47347207Q00000X
LAMD.204074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine