Individual
DR. DAVID BLAKE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5420 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2083
(405) 947-6828
(405) 946-3346
Mailing address
5420 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2083
(405) 947-6828
(405) 946-3346
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17414
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17414
PHARMACIST STATE LICENSE NUMBER
OK
Enumeration date
06/18/2019
Last updated
06/18/2019
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