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General NPI Number Information
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NPI Number | 1295966927
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Entity Type | Individual
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Provider Name | MEGAN LYNN SMITH O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 537 W KARSCH BLVD
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City | FARMINGTON
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State | MO
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Zip | 63640-3312
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Country | US
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Telephone | 573-747-4133
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Fax | 573-747-4533
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Provider Business Mailing Address
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Address Line | 105 SCIENCE ST
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City | PARK HILLS
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State | MO
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Zip | 63601-2529
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Country | US
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Telephone | 573-200-8732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC004476
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2009019492
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License Number State | MO
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