MEDICARE: DR. DANIEL ERIN SMITH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2824	TN
2	152W00000X	Optometrist	2965	CO
3	152WP0200X	Pediatric Optometrist	2965	CO
4	152W00000X	Optometrist	14433	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2965	OTHER	CO	OPTOMETRY LICENSE
4	2824	OTHER	TN	TN

General Provider Information

NPI Number	:	1033163837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL ERIN SMITH O.D.

Provider Business Mailing Address
First Line	:	PO BOX 110429
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80042-0429
Country	:	US
Telephone Number	:	303-493-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	30952 S INDIAN HILLS RD
Second Line	:
City	:	OSAGE CITY
State	:	KS
Zip	:	66523-9089
Country	:	US
Telephone Number	:	785-979-1570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	03/01/2024

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