Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 28110 | OK |
NPI | 1265417687 |
---|---|
Provider Name | Jennifer G Smith |
First Address | Oklahoma City, OK 73120-8366 |
Second Address | Oklahoma City, OK 73120-8366 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 10/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10186714 | (05) | VA |
1391R | BCBS (01) | |
200314200A | (05) | OK |
7959719 | AETNA (01) | |
80768 | PARTNERS (01) | |
E4094 | MEDCOST (01) |