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General NPI Number Information
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NPI Number | 1629267794
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Entity Type | Organization
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Legal Business Name | F E SMITH O D INC
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 401 E CHEROKEE AVE
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City | MCALESTER
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State | OK
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Zip | 74501-5333
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Country | US
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Telephone | 918-423-3043
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Fax | 918-420-5705
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Provider Business Mailing Address
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Address Line | PO BOX 1045
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City | MCALESTER
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State | OK
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Zip | 74502-1045
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Country | US
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Telephone | 918-423-3043
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Fax | 918-420-5705
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MR. F E SMITH
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Credential | O D
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Telephone | 918-423-3043
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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 |
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License Number State |
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