Individual
CHARLES L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
59390 E 288 CT, GROVE, OK 74344-7735
(918) 787-9997
Mailing address
59390 E 288 CT, GROVE, OK 74344-7735
(918) 787-9997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3528
OK
Other
Enumeration date
06/12/2013
Last updated
06/12/2013
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