Provider Demographics
NPI:1578604989
Name:SMITH, CHAD MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:MICHAEL
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:920 STANTON L. YOUNG
Mailing Address - Street 2:WP 2430
Mailing Address - City:OKLA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-271-7449
Mailing Address - Fax:405-271-8762
Practice Address - Street 1:825 NE 10TH
Practice Address - Street 2:SUITE 3300
Practice Address - City:OKLA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-5239
Practice Address - Fax:405-271-3727
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK25014207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology