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Individual

DR. WILLIAM KEITH SMITH JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1627 N KICKAPOO AVE, SHAWNEE, OK 74804-4313
(405) 275-8234
(405) 275-7298
Mailing address
1627 N KICKAPOO AVE, SHAWNEE, OK 74804-4313
(405) 275-8234
(405) 275-7298

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
205
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100779890C
OK
01
P01598903
RAILROAD MEDICARE
OK
Enumeration date
11/17/2005
Last updated
03/09/2016
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