Provider Demographics
NPI:1447260351
Name:SMITH, BARRY NEIL (DPH)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:NEIL
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 PARKVIEW DR STE 3
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-2145
Mailing Address - Country:US
Mailing Address - Phone:405-262-4154
Mailing Address - Fax:405-262-0912
Practice Address - Street 1:2005 PARKVIEW DR STE 3
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-2145
Practice Address - Country:US
Practice Address - Phone:405-262-4154
Practice Address - Fax:405-262-0912
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11415183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist