Individual
JOHNNY R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2301 S EIGHT TRIBES TRL, MIAMI, OK 74354-1009
(918) 542-1655
Mailing address
2301 S EIGHT TRIBES TRL, PO BOX 1498, MIAMI, OK 74354-1009
(918) 542-1655
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
R0074090
OK
Other
Enumeration date
01/11/2011
Last updated
01/11/2011
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