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Individual

FRANK JAY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
109 KERR AVE, POTEAU, OK 74953-5270
(918) 649-1100
Mailing address
10801 OKLAHOMA ROAD, HACKETT, AR 72937
(479) 312-9274

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA03545
TX
363AM0700X
Medical Physician Assistant
Primary
PA982
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
165646401
TX
Enumeration date
12/22/2005
Last updated
09/26/2017
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