Malcolm Derek Smith, Dpm Pc

LBN: Malcolm Derek Smith, Dpm Pc
Malcolm Derek Smith, Dpm Pc is an health care organization with primary practice located at 1700 N 5Th St , Ponca City OK 74601-2762. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Malcolm Derek Smith, Dpm Pc can be contacted via phone (580) 765-3389, or through Smith, Jennifer Rae via phone (580) 765-3389.

Contact Information

Primary practice address
1700 N 5Th St Ponca City OK 74601-2762
Phone: (580) 765-3389
Fax: (580) 762-3994
Website:
Map and Directions
Authorized official contact:
Name: Smith, Jennifer Rae
Phone: (580) 765-3389

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 198 Oklahoma

Profile Details

NPI number 1285803049
LBN Legal business name Malcolm Derek Smith, Dpm Pc
DBA Doing business as
Authorized official Smith, Jennifer Rae
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2008
Last updated Feb 26th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285803049 NPPES
Oklahoma MEDICAID 100779800A
Oklahoma Other 294540038001

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