John Douglas Smiley, DC
Individual provider Active NPI Chiropractor · Colcord, OK
NPI 1508893546 · NPPES record last updated Dec 18, 2008
Key facts
- NPI
- 1508893546
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2567 (OK)
- Practice address
- 768 Stateline Rd
Colcord, OK 74338-1346 - Phone
- (918) 422-6118
- Fax
- (918) 422-6192
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2567 | OK | Yes |
Addresses
Primary practice location
768 Stateline Rd
Colcord, OK 74338-1346
Mailing address
PO Box 1181
Siloam Springs, AR 72761-1181
Phone (918) 422-6118
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100832070A | Medicaid | OK |
Other providers in Colcord, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.