MEDICARE: DR. MEGAN LYNN 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	OPC004476	FL
2	152W00000X	Optometrist	2009019492	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000006438	OTHER	MO	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295966927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEGAN LYNN SMITH O.D.

Provider Business Mailing Address
First Line	:	105 SCIENCE ST
Second Line	:
City	:	PARK HILLS
State	:	MO
Zip	:	63601-2529
Country	:	US
Telephone Number	:	573-200-8732
Fax Number	:

Provider Business Practice Location Address
First Line	:	537 W KARSCH BLVD
Second Line	:
City	:	FARMINGTON
State	:	MO
Zip	:	63640-3312
Country	:	US
Telephone Number	:	573-747-4133
Fax Number	:	573-747-4533

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

Provider Enumeration Date	:	07/29/2009
Last Update Date	:	06/26/2024

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