Provider Demographics
NPI:1740540228
Name:SMITH, JAMES ALBERTO (LAC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALBERTO
Last Name:SMITH
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 792413
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70179-2413
Mailing Address - Country:US
Mailing Address - Phone:504-858-1295
Mailing Address - Fax:504-264-5489
Practice Address - Street 1:4322 CANAL ST
Practice Address - Street 2:SUITE 5
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5945
Practice Address - Country:US
Practice Address - Phone:504-858-1295
Practice Address - Fax:504-264-5489
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAACA200038171100000X
ORAC156785171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist