Smith, Jerry Alton
Smith, Jerry Alton is an individual health care provider with primary practice located at 902 S Vienna St , Ruston LA 71270-5830. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Jerry Alton can be contacted via phone (318) 513-1950.Contact Information
Primary practice address
902 S Vienna St
Ruston LA 71270-5830
Phone: (318) 513-1950
Fax: (318) 513-1952
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 018988 | Louisiana |
Profile Details
| NPI number | 1417996448 |
|---|---|
| LBN Legal business name | Smith, Jerry Alton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Jul 31st, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417996448 | NPPES |
| Louisiana | MEDICAID | 1691542 |
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