Individual
MR. DEREK J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(539) 593-1299
Mailing address
6333 SKELLY DRIVE, TULSA, OK 74145
(918) 720-3812
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0064110
OK
164W00000X
Licensed Practical Nurse
064110
OK
Other
Enumeration date
06/28/2023
Last updated
10/09/2024
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