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Individual

LESLEY JEANINE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
709 N CZECH HALL RD, YUKON, OK 73099-7897
(405) 494-8600
(405) 494-8567
Mailing address
709 N CZECH HALL RD, YUKON, OK 73099-7897
(405) 494-8600
(405) 494-8567

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
825
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100108200A
OK
01
970018308
RR MEDICARE
OK
Enumeration date
05/02/2006
Last updated
01/12/2026
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