# SMITH PODIATRIC SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AFFILIATED FOOT & ANKLE CLINICS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376676494
- **Authorized official:** MS. CHERYL A WATTS (OFFICE MANAGER)
- **Authorized official phone:** (405) 275-8234

## Contact information

- **Practice address:** 1627 N KICKAPOO AVE, SHAWNEE, OK 74804-4313
- **Practice address phone:** (405) 275-8234
- **Practice address fax:** (405) 275-7298
- **Mailing address:** 1627 N KICKAPOO AVE, SHAWNEE, OK 74804-4313
- **Mailing address phone:** (405) 275-8234
- **Mailing address fax:** (405) 275-7298

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 152 | OK | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 205 | OK | — |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 11/23/2010