Ethel Stackhouse Smith, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

LA9038 Issued in LA

Practice address

125 Karolwood Dr
Lafayette, LA 70503

Phone

(337) 984-1924

Fax

(337) 981-0492

NPI assigned

May 12, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1194017889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 KAROLWOOD DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70503",
            "telephone_number": "337-984-1924",
            "fax_number": "337-981-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 KAROLWOOD DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70503",
            "telephone_number": "337-984-1924",
            "fax_number": "337-981-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ETHEL",
        "middle_name": "STACKHOUSE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "LA9038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chester Cory Smith, PHD, NP-C
• Delisa Rae Smith, FNP
• Deondra Leigh Smith, LPC
• Devin Smith
• Elizabeth Renee Smith, M.D.
• James Jerome Smith, D.D.S.
• Jamie N Smith, MPH, P.A.-C
• Jasmine Raye Smith
• Jeanne Patricia Smith, CIT
• Jordan Smith, DNP-NA, CRNA

• Surgery Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.