Individual
JOHN R SMITHSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 NEO LOOP, GROVE, OK 74344-6046
(918) 786-9568
(918) 293-3116
Mailing address
1120 NEO LOOP, GROVE, OK 74344-6046
(918) 786-9568
(918) 293-3116
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
11399
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100088280A
—
OK
Enumeration date
08/23/2005
Last updated
11/07/2012
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