Individual
MRS. KRISTINA LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9645 RIVERSIDE PKWY STE C, TULSA, OK 74137-7427
(918) 209-5170
(918) 209-5187
Mailing address
9645 RIVERSIDE PKWY STE C, TULSA, OK 74137-7427
(918) 209-5170
(918) 209-5187
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5442
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200494810B
—
OK
01
—
747279
MEDICARE
OK
Enumeration date
05/17/2012
Last updated
02/12/2019
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