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NPI Code Detail

MEDICARE: LESLEY JEANINE SMITH P.A.

MEDICARE:   LESLEY JEANINE SMITH  P.A.
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
1363A00000XPhysician Assistant825OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2970018308OTHEROKRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740248582
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLEY JEANINE SMITH P.A.
Provider Business Mailing Address
First Line : 709 N CZECH HALL RD
Second Line :
City : YUKON
State : OK
Zip : 73099-7897
Country : US
Telephone Number : 405-494-8600
Fax Number : 405-494-8567
Provider Business Practice Location Address
First Line : 709 N CZECH HALL RD
Second Line :
City : YUKON
State : OK
Zip : 73099-7897
Country : US
Telephone Number : 405-494-8600
Fax Number : 405-494-8567
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 01/12/2026

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Directions to “ LESLEY JEANINE SMITH P.A.” Practice Location

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