Healthcare Provider Details

I. General information

NPI: 1033515762
Provider Name (Legal Business Name): GREGORY ALLAN SMITH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S TELEPHONE RD STE 150
MOORE OK
73160-2972
US

IV. Provider business mailing address

2900 S TELEPHONE RD STE 150
MOORE OK
73160-2972
US

V. Phone/Fax

Practice location:
  • Phone: 405-793-8777
  • Fax: 405-793-1089
Mailing address:
  • Phone: 405-793-8777
  • Fax: 405-793-1089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33138
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4177
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: