Healthcare Provider Details

I. General information

NPI: 1871765867
Provider Name (Legal Business Name): WILLIAM E SMITH MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 RENAISSANCE BLVD
EDMOND OK
73013-3022
US

IV. Provider business mailing address

PO BOX 5650
EDMOND OK
73083-5650
US

V. Phone/Fax

Practice location:
  • Phone: 405-844-4323
  • Fax: 405-948-6507
Mailing address:
  • Phone: 405-844-4323
  • Fax: 405-948-6507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM E SMITH
Title or Position: OWNER
Credential: MD
Phone: 405-844-4323