Organization
JOHN O SMITH OPTOMETRIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN O SMITH OD (OWNER)
(405) 853-6800
Entity
Organization
Contact information
Practice address
1201 S MAIN ST, HENNESSEY, OK 73742-1744
(405) 853-6800
Mailing address
1201 S MAIN ST, HENNESSEY, OK 73742-1744
(405) 853-6800
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1014
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100763790A
—
OK
01
—
1043277791
RETIRED RAILROAD MEDICARE
OK
Enumeration date
01/31/2007
Last updated
10/10/2012
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