Individual
DR. KIRK M. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4909 SE MILLS AVE, LAWTON, OK 73501-8705
(580) 890-0545
Mailing address
4909 SE MILLS AVE, LAWTON, OK 73501-8705
(580) 890-0545
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
23307
OK
207Q00000X
Family Medicine Physician
Primary
23307
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200019910A
—
OK
01
—
800522535
MEDICARE GROUP PIN
OK
Enumeration date
10/25/2005
Last updated
03/08/2013
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