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General NPI Number Information
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NPI Number | 1659485373
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Entity Type | Individual
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Provider Name | VIVIEN MARY SMITH OD
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 3735 PALOMAR CENTRE DR SUITE #45
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City | LEXINGTON
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State | KY
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Zip | 40513-1147
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Country | US
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Telephone | 859-224-8083
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Fax | 859-223-2913
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Provider Business Mailing Address
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Address Line | PO BOX 910824
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City | LEXINGTON
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State | KY
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Zip | 40591-0824
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Country | US
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Telephone | 859-224-8083
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Fax | 859-223-2913
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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 | 1223DT
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License Number State | KY
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