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DR. COURTLAND PRENTICE SMITH M.D.

>> Otolaryngology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1043371198

Individual Registrant:
DR. COURTLAND PRENTICE SMITH M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
26300 SOUTH HWY 125  AFTON, OK 74331 US
Tel: 918-257-8585  Fax: 918-257-8560

Contact information for business:
26300 SOUTH HWY 125  AFTON, OK 74331 US
Tel: 918-257-8585  Fax: 918-257-8560

Registration Information:
NPI: 1043371198
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Y00000XAllopathic & Osteopathic Physicians
Otolaryngology
OK25369
N207Y00000XAllopathic & Osteopathic Physicians
Otolaryngology
MO107833

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
207948209MO05
BLUE CROSS BLUE SHIELD19859MO01
128329001AR05
BLUE CROSS BLUE SHIELD97588AR01




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