Individual
DR. JEFFREY J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 RENAISSANCE BLVD, STE 210, EDMOND, OK 73013-3023
(405) 470-6767
(405) 470-6768
Mailing address
PO BOX 5645, EDMOND, OK 73083-5645
(405) 470-6767
(405) 470-6768
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14140
OK
207VG0400X
Gynecology Physician
14140
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100826770B
—
OK
Enumeration date
05/15/2006
Last updated
01/09/2019
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