MEDICARE: DR. JAMES W SMITH DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	J7851	TX
2	207V00000X	Obstetrics & Gynecology Physician	E12087	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	160047109	OTHER	TX	RAILROAD MEDICARE PROV NU

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5219585	OTHER	TX	AETNA PROVIDER NUMBER
2	124287100	OTHER	TX	FIRST CARE PROVIDER NUMBE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	89750J	OTHER	TX	BCBS IND PROVIDER NUMBER
7	3248101001	OTHER	TX	CIGNA PROVIDER NUMBER

General Provider Information

NPI Number	:	1053316745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES W SMITH DO

Provider Business Mailing Address
First Line	:	4140 W MEMORIAL RD STE 321
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8300
Country	:	US
Telephone Number	:	405-748-4726
Fax Number	:	405-607-8497

Provider Business Practice Location Address
First Line	:	2710 S RIFE MEDICAL LN FL 5
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-1452
Country	:	US
Telephone Number	:	405-748-4726
Fax Number	:	405-607-8497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	03/15/2023

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Directions to “ DR. JAMES W SMITH DO” Practice Location

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