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Individual

MICHAEL S. SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.R.N.P.

Contact information

Practice address
1118 W BROADWAY ST, MUSKOGEE, OK 74401-6246
(918) 681-4646
(918) 684-9023
Mailing address
1118 W BROADWAY ST, MUSKOGEE, OK 74401-6246
(918) 681-4646
(918) 684-9023

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0035256
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100218890A
OK
Enumeration date
10/26/2005
Last updated
04/14/2008
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