Individual
LISA J WASEMILLER-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11200 N PORTLAND AVE, OKLAHOMA CITY, OK 73120-5045
(405) 936-1100
(405) 936-1122
Mailing address
11200 N PORTLAND AVE, OKLAHOMA CITY, OK 73120-5045
(405) 936-1100
(405) 936-1122
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD13137
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100824630A
—
OK
05
—
100824630C
—
OK
Enumeration date
07/05/2005
Last updated
05/15/2008
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