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Contact Information

MALCOLM D SMITH, DPM
1700 N 5TH ST
PONCA CITY, OK74601-2762
 Phone: 580-765-3389
 Fax: 580-762-3994
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for MALCOLM D SMITH · (Male)

NPI # 1093732562
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/17/2006
Last updated 04/22/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 198
  • OK Medicaid 100779800A
Hospital affiliation(s)
  • PONCA CITY MEDICAL CENTER - (Acute Care)
    1900 NORTH 14TH STREET
    PONCA CITY, OK 74601
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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