MEDICARE: DR. JAMES WAYNE SMITH M.D., PH.D.

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	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	16563	OK

General Provider Information

NPI Number	:	1093910309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES WAYNE SMITH M.D., PH.D.

Provider Business Mailing Address
First Line	:	1001 N LINCOLN BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-3251
Country	:	US
Telephone Number	:	405-297-5504
Fax Number	:	405-297-5541

Provider Business Practice Location Address
First Line	:	1001 N LINCOLN BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-3251
Country	:	US
Telephone Number	:	405-297-5504
Fax Number	:	405-297-5541

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	07/08/2007

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