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NPI Code Detail

MEDICARE: DR. NEAL CHARLES SMALL M.D.

MEDICARE: DR. NEAL CHARLES SMALL M.D.
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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician24271OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
124271OTHEROKOKLAHOMA MEDICAL LICENSE

General Provider Information

NPI Number : 1437393931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NEAL CHARLES SMALL M.D.
Provider Business Mailing Address
First Line : 2007 N COMMERCE ST
Second Line : SUITE 201
City : ARDMORE
State : OK
Zip : 73401-1268
Country : US
Telephone Number : 580-226-4599
Fax Number : 580-226-4599
Provider Business Practice Location Address
First Line : 2007 N COMMERCE ST
Second Line : SUITE 201
City : ARDMORE
State : OK
Zip : 73401-1268
Country : US
Telephone Number : 580-226-4599
Fax Number : 580-226-4599
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 07/26/2010

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Directions to “ DR. NEAL CHARLES SMALL M.D.” Practice Location

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