NPI 1528036704
Jack Bradley Smith, PA
Physician Assistant · Oklahoma City, OK
Active in the CMS NPI RegistryNot on the OIG exclusion listchecked Oct 16, 2026, 1:07 pm EDT
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Jack Bradley Smith, PA is a health care provider (Physician Assistant) in Oklahoma City, Oklahoma with National Provider Identifier (NPI) 1528036704. The NPI was issued on Mar 14, 2006 and the registry record was last updated on Dec 1, 2025. The registry lists a license in Oklahoma.
Registry record
- NPI
- 1528036704
- Type
- Individual (NPI-1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice location
- 4401 W Memorial Rd
Oklahoma City, OK 73134-1785 - Phone
- (405) 751-4664
- NPI issued
- Mar 14, 2006
- Registry record updated
- Dec 1, 2025
Specialties and licenses
| Specialty | Taxonomy code | License state | License |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | Oklahoma | 1155 |
Confirm license status and discipline with the state board (links in NPI Lookup).
Physician Assistant providers in Oklahoma
- Justin Cole Druskis, PA-CArdmore, OK
- Amber Christine Duncan, PAGrove, OK
- Andrew Wong, PA-COklahoma City, OK
Source: CMS National Plan and Provider Enumeration System (NPPES) and the HHS-OIG List of Excluded Individuals/Entities (list of Oct 9, 2026). Is this your record? Update it in NPPES or email info@2minutemedicine.com to have it hidden here.