Organization
LISA J WASEMILLER-SMITH MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA WASEMILLER-SMITH M.D. (OWNER)
(405) 936-1100
Entity
Organization
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
13137
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100824630A
—
OK
05
—
100824630C
—
OK
Enumeration date
09/16/2008
Last updated
11/22/2010
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