Individual
DR. LARRY DEAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
914 AVENUE G, FORT MADISON, IA 52627-4530
(319) 372-5181
(319) 372-0865
Mailing address
914 AVENUE G, FORT MADISON, IA 52627-4530
(319) 372-5181
(319) 372-0865
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1601
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044214
—
IA
Enumeration date
02/21/2006
Last updated
10/01/2007
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