MEDICARE: MARSHA SMITH

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	171M00000X	Case Manager/Care Coordinator	UNEMPLOYED

General Provider Information

NPI Number	:	1649604067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHA SMITH

Provider Business Mailing Address
First Line	:	3354 N GARRISON AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-1815
Country	:	US
Telephone Number	:	918-645-1128
Fax Number	:	918-425-9845

Provider Business Practice Location Address
First Line	:	3354 N GARRISON AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-1815
Country	:	US
Telephone Number	:	918-645-1128
Fax Number	:	918-425-9845

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

Provider Enumeration Date	:	08/22/2013
Last Update Date	:	08/22/2013

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Directions to “ MARSHA SMITH ” Practice Location

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