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NPI 1114118643

IndividualActive

Brian Smith, PRESIDENT

NPI 1114118643 · Specialist · Oklahoma City, OK

Provider details

NPI number: 1114118643
Entity type: Individual
Primary specialty: SpecialistOther Service Providers
Credential: PRESIDENT
Sex: Male
Sole proprietor: Yes
License: 24186 (OK)

Practice location

6718 S Western Ave

Oklahoma City, OK 73139-1807

Phone: (405) 602-1053

Fax: (405) 602-1059

More OK providers

Mailing address

6718 S Western Ave

Oklahoma City, OK 73139-1807

Registry dates

Enumerated: 2007-08-08
Last updated: 2007-08-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Brian Smith, PRESIDENT — NPI 1114118643, Oklahoma City, OK | NPI Central