Individual
DEREK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN-CNP
Contact information
Practice address
1105 MICHELIN RD, ARDMORE, OK 73401-1085
(580) 224-8750
Mailing address
20 12TH AVE NW, ARDMORE, OK 73401-5722
(580) 223-3411
(580) 226-6213
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
102505
OK
Other
Enumeration date
09/18/2019
Last updated
03/27/2025
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