MEDICARE: ARNOLD SMITH M.H.R., LADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	394	OK

General Provider Information

NPI Number	:	1174935290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARNOLD SMITH M.H.R., LADC

Provider Business Mailing Address
First Line	:	6110 NW 63RD ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-7526
Country	:	US
Telephone Number	:	405-946-7337
Fax Number	:	405-603-5983

Provider Business Practice Location Address
First Line	:	6110 NW 63RD ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-7526
Country	:	US
Telephone Number	:	405-946-7337
Fax Number	:	405-603-5983

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	05/22/2014

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