MEDICARE: MICHAEL S SMITH M.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	208100000X	Physical Medicine & Rehabilitation Physician	18758	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	250005065	OTHER	OK	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689610719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL S SMITH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 960261
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73196-0001
Country	:	US
Telephone Number	:	405-605-8780
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 N BROOKLINE AVE
Second Line	:	STE 500
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3623
Country	:	US
Telephone Number	:	405-605-8780
Fax Number	:

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

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	03/20/2009

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Directions to “ MICHAEL S SMITH M.D.” Practice Location

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