Individual
DR. RAYMOND W SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 E LINCOLN RD, IDABEL, OK 74745-7300
(580) 208-3159
Mailing address
1301 E LINCOLN RD, IDABEL, OK 74745-7300
(580) 208-3159
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24208
OK
2085R0202X
Diagnostic Radiology Physician
424834
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100165840B
—
KS
Enumeration date
08/15/2005
Last updated
06/30/2010
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