Healthcare Provider Details
I. General information
NPI: 1932056843
Provider Name (Legal Business Name): BAKARI OBASI-LEE SMITH CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1317 N BRIGHTLEAF BLVD
SMITHFIELD NC
27577-7267
US
IV. Provider business mailing address
1208 RIDGE WOOD ST
DURHAM NC
27713-1288
US
V. Phone/Fax
- Phone: 984-230-2577
- Fax:
- Phone: 919-943-1636
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 222Z00000X |
| Taxonomy | Orthotist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224P00000X |
| Taxonomy | Prosthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: