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Contact Information

MALCOLM DEREK SMITH, DPM PC
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 DEREK SMITH, DPM PC

NPI # 1285803049
LBN Legal business name MALCOLM DEREK SMITH, DPM PC
Authorized official JENNIFER SMITH - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/26/2008
Last updated 02/26/2008 - About 18 years ago
Identifiers
OK License # 198
OK Medicaid 100779800A
OK Other 294540038001 BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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