Doctor Name: | JOHN O. SMITH |
NPI Number: | 1043277791 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | 1014 |
Business Practice Address: | 1201 S Main St Hennessey, OK - 737421744 |
Business Phone Number: | 4058536800 |
Business Fax Number: | 4058536805 |
Mailing Address: | Po Box 654, HENNESSEY |
State: | OK |
Postal Code: | 737420654 |
Phone Number: | 4058536800 |
Fax Number: | 4058536805 |
NPI Enumeration Date: | 04/27/2006 |
NPI Last Update Date: | 03/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 1014 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |