Provider Demographics
NPI:1861210320
Name:SMITH, WILLIAM LEIGH
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 E WORTHY ST STE B-2
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-4359
Mailing Address - Country:US
Mailing Address - Phone:225-450-3216
Mailing Address - Fax:225-450-3799
Practice Address - Street 1:1058 E WORTHY ST STE B-2
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4359
Practice Address - Country:US
Practice Address - Phone:225-450-3216
Practice Address - Fax:225-450-3799
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator