E. Clyde Smoot, M.D.-LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

MD12854R Issued in LA

Legal business name

E. CLYDE SMOOT, M.D.-LLC

Doing business as

Lake Charles Plastic Surgery

Practice address

4150 Nelson Rd
BLDG a Ste 2
Lake Charles, LA 70605-4148

Phone

(337) 478-5577

Fax

(337) 478-5588

NPI assigned

Oct 30, 2007

Last updated

Oct 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ernest Clyde Smoot, M.D.NPI 1790756039

Title

Owner

Phone

(337) 478-5577

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LAKE CHARLES PLASTIC SURGERY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ernest Clyde Smoot, MD

  • Plastic and Reconstructive Surgery Physician
  • Lake Charles, LA
  • NPI 1790756039
  Authorized official Same address or phone

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1528247277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "BLDG A STE 2",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054148",
            "telephone_number": "337-478-5577",
            "fax_number": "337-478-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD",
            "address_2": "BLDG A STE 2",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054148",
            "telephone_number": "337-478-5577",
            "fax_number": "337-478-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. CLYDE SMOOT, M.D.-LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "SMOOT",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "CLYDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-478-5577",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "LA",
            "license": "MD12854R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1978671",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKE CHARLES PLASTIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Trahan Dyer, APRN, APMHNP-BC
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• Julie Susann Dyrek, PMHNP-C APRN
• Ebony Eaglin, MSN, APRN, FNP-BC
• Tonya Eaglin
• Andrew Keith Eakin, DPT
• Sherrie Tilley Eakin, MSN, FNP-C
• Paula Ducote Eapen, MD

• Plastic and Reconstructive Surgery Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Plastic and Reconstructive Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.