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General NPI Number Information
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NPI Number | 1104972629
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Entity Type | Organization
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Legal Business Name | DAVID L & STANLEY J SMITH PTRS
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 8510 NORTH 123RD EAST AVENUE
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City | OWASSO
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State | OK
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Zip | 74055
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Country | US
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Telephone | 918-272-1138
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Fax | 918-274-2931
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Provider Business Mailing Address
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Address Line | 8510 NORTH 123RD EAST AVENUE
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City | OWASSO
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State | OK
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Zip | 74055
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Country | US
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Telephone | 918-272-1138
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Fax | 918-274-2931
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Authorized Official
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Title or Position | PARTNER
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Name | DR. STANLEY JOE SMITH
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Credential | D.O.
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Telephone | 918-272-1138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | OK
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