Healthcare Provider Details

I. General information

NPI: 1558385708
Provider Name (Legal Business Name): REGINA MARIE RHOADES D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REGINA MARIE SMITH D.P.M.

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4913 W RENO AVE
OKLAHOMA CITY OK
73127-6339
US

IV. Provider business mailing address

1125 N PORTER AVE STE 300
NORMAN OK
73071-6443
US

V. Phone/Fax

Practice location:
  • Phone: 405-948-4900
  • Fax: 405-948-4933
Mailing address:
  • Phone: 405-307-8503
  • Fax: 405-307-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: