Provider Demographics
NPI:1134122534
Name:CINDY L. SMITH
Entity Type:Organization
Organization Name:CINDY L. SMITH
Other - Org Name:LYNN'S ORTHOPEDIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LO, LPED
Authorized Official - Phone:405-366-0184
Mailing Address - Street 1:8121 S WESTERN AVE
Mailing Address - Street 2:STE I
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2546
Mailing Address - Country:US
Mailing Address - Phone:405-366-0184
Mailing Address - Fax:405-604-6818
Practice Address - Street 1:8121 S WESTERN AVE
Practice Address - Street 2:STE I
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2546
Practice Address - Country:US
Practice Address - Phone:405-366-0184
Practice Address - Fax:405-604-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLO 20,LPED 27, LPO47335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1255990001Medicare NSC