Provider Demographics
NPI:1215538350
Name:SMITH, CHRISTOPHER B (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:B
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15212 E 108TH PL N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-8192
Mailing Address - Country:US
Mailing Address - Phone:918-851-1870
Mailing Address - Fax:
Practice Address - Street 1:19801 ROBSON RD
Practice Address - Street 2:
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-1510
Practice Address - Country:US
Practice Address - Phone:918-739-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist