Provider Demographics
NPI:1952655334
Name:SMITH, DANIEL CASS (BA, BHRS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:CASS
Last Name:SMITH
Suffix:
Gender:M
Credentials:BA, BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 N PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1710
Mailing Address - Country:US
Mailing Address - Phone:405-372-2913
Mailing Address - Fax:405-372-1328
Practice Address - Street 1:4806 N PERKINS RD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-1710
Practice Address - Country:US
Practice Address - Phone:405-372-2913
Practice Address - Fax:405-372-1328
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker