Individual
MRS. GINA RENEA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5801 E 41ST ST STE 900, TULSA, OK 74135-5631
(918) 747-4975
(918) 743-8552
Mailing address
PO BOX 4930, TULSA, OK 74159-0930
(918) 747-4975
(918) 743-8552
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1114
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100138330A
—
OK
Enumeration date
06/27/2005
Last updated
04/22/2024
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