Provider Demographics
NPI:1992780001
Name:SMITH, WILLIAM D (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:226 SE DEBELL
Mailing Address - Street 2:BLDG A
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006
Mailing Address - Country:US
Mailing Address - Phone:918-335-2511
Mailing Address - Fax:918-333-3478
Practice Address - Street 1:222 SE DEBELL
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006
Practice Address - Country:US
Practice Address - Phone:918-335-2511
Practice Address - Fax:918-333-3478
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8866207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100121700AMedicaid
D91079Medicare UPIN