Healthcare Provider Details

I. General information

NPI: 1619829207
Provider Name (Legal Business Name): METRIA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6128 E 38TH ST
TULSA OK
74135-5832
US

IV. Provider business mailing address

2302 W 33RD ST N
TULSA OK
74127-3519
US

V. Phone/Fax

Practice location:
  • Phone: 918-770-5608
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: