Provider Demographics
NPI:1205157104
Name:SMITH, LAURA B (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:2782 WASHINGTON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1013
Mailing Address - Country:US
Mailing Address - Phone:405-400-1152
Mailing Address - Fax:405-217-4383
Practice Address - Street 1:2782 WASHINGTON DR STE 100
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1013
Practice Address - Country:US
Practice Address - Phone:405-400-1152
Practice Address - Fax:405-217-4383
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK279992084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry