Provider Demographics
NPI:1992828594
Name:CORBY SMITHTON, D.O., P.C.
Entity Type:Organization
Organization Name:CORBY SMITHTON, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORBY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITHTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-533-2433
Mailing Address - Street 1:1921 W 6TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4204
Mailing Address - Country:US
Mailing Address - Phone:405-533-2433
Mailing Address - Fax:405-533-2434
Practice Address - Street 1:1921 W 6TH AVE STE A
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4204
Practice Address - Country:US
Practice Address - Phone:405-533-2433
Practice Address - Fax:405-533-2434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK400522236Medicare PIN