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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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