Individual
MICHAEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3844 NW 8TH ST, OKLAHOMA CITY, OK 73107-6062
(405) 227-0694
Mailing address
3844 NW 8TH ST, OKLAHOMA CITY, OK 73107-6062
(405) 227-0694
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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