Healthcare Provider Details

I. General information

NPI: 1720268550
Provider Name (Legal Business Name): REGINA M. SMITH, DPM INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2007
Last Update Date: 12/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 MCGEE DR SUITE 106
NORMAN OK
73072-5774
US

IV. Provider business mailing address

1300 MCGEE DR SUITE 106
NORMAN OK
73072-5774
US

V. Phone/Fax

Practice location:
  • Phone: 405-307-8503
  • Fax:
Mailing address:
  • Phone: 405-307-8503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number196
License Number StateOK

VIII. Authorized Official

Name: DR. REGINA MARIE RHOADES
Title or Position: OWNER/PODIATRIST
Credential: DPM
Phone: 405-307-8503