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General NPI Number Information
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NPI Number | 1962679662
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Entity Type | Organization
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Legal Business Name | BOYS SMITH VISION CENTER MEDICAL PLLC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 109 N PINE ST
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City | ELLENSBURG
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State | WA
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Zip | 98926-3330
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Country | US
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Telephone | 509-962-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 109 N PINE ST
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City | ELLENSBURG
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State | WA
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Zip | 98926-3330
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Country | US
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Telephone | 509-962-3937
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICK JOHN BOYS SMITH
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Credential |
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Telephone | 509-962-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD00027188
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License Number State | WA
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