| Bradford J Smith, MD | |
|
6516 E Myrtle Ave, Baker, LA 70714-4348 | |
| (225) 774-7320 | |
| (225) 774-5432 |
| Full Name | Bradford J Smith |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 31 Years |
| Location | 6516 E Myrtle Ave, Baker, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144271602 | NPI | - | NPPES |
| 15555843 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 13053R (Louisiana) | Secondary |
| 207R00000X | Internal Medicine | 13053R (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lane Home Health An Affiliate Of Lane Reg Medical | Zachary, LA | Home health agency |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Our Lady Of The Lake Physician Group Llc | 4587849781 | 579 |
| Entity Name | Our Lady Of The Lake Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradford J Smith, MD 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 765-5727 | Bradford J Smith, MD 6516 E Myrtle Ave, Baker, LA 70714-4348 Ph: (225) 774-7320 |
Dr. Mark Christian Mouton, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 12880 Plank Rd, Baker, LA 70714 Phone: 225-774-7111 Fax: 225-774-7111 | |
Dr. Kristin Lynch Grimes, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 6516 E Myrtle Ave, Baker, LA 70714 Phone: 225-774-7320 Fax: 225-774-5432 | |
Ernest Gene Thompson Jr., MD Internal Medicine Medicare: May Accept Medicare Assignments Practice Location: 12902 Plank Rd, Baker, LA 70714 Phone: 225-774-0733 Fax: 225-774-7777 | |
Kent M Rhodes, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 6516 E Myrtle Ave, Baker, LA 70714 Phone: 225-765-5500 Fax: 225-774-5432 |