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Physician Compare National (NPI:1205199247)

HEALTHCARE PROVIDER: TONYA MARIE SMITH UMBEL OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1205199247
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 5193958353
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20170519001488
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name UMBEL
Individual professional last name
Provider First Name TONYA
Individual professional first name
Provider Middle Name MARIE
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Individual professional's medical school
Graduation Year 2012
Individual professional's medical school graduation year
Primary Specialty OPTOMETRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name FICK EYECARE, INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 5193817427
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 3
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 536 EMILY DR B
Group Practice or individual's line 1 address
City CLARKSBURG
Group Practice or individual's city
State WV
Group Practice or individual's state
Zip Code 263015507
Group Practice or individual's zip code (9 digits when available)
Phone Number 3045667709
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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