Individual
MARK ALAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2617 GENERAL PERSHING BLVD, OKLAHOMA CITY, OK 73107-6437
(405) 858-2700
Mailing address
PO BOX 12978, OKLAHOMA CITY, OK 73157-2978
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
116239
OK
Other
Enumeration date
04/21/2018
Last updated
04/21/2018
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