Provider Demographics
NPI:1053316745
Name:SMITH, JAMES W (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4140 W MEMORIAL RD STE 321
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8300
Mailing Address - Country:US
Mailing Address - Phone:405-748-4726
Mailing Address - Fax:405-607-8497
Practice Address - Street 1:2710 S RIFE MEDICAL LN FL 5
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:405-748-4726
Practice Address - Fax:405-607-8497
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ7851207V00000X
ARE12087207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5219585OtherAETNA PROVIDER NUMBER
TX124287100OtherFIRST CARE PROVIDER NUMBE
TX160047109OtherRAILROAD MEDICARE PROV NU
OK2Q5007Medicaid
TX106168105Medicaid
TX89750JOtherBCBS IND PROVIDER NUMBER
TX3248101001OtherCIGNA PROVIDER NUMBER
TX160047109OtherRAILROAD MEDICARE PROV NU