Individual
J. KYLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
450 N MCPHERSON ST, FORT BRAGG, CA 95437-3314
(707) 964-5927
(707) 964-6533
Mailing address
450 N MCPHERSON ST, FORT BRAGG, CA 95437-3314
(707) 964-5927
(707) 964-6533
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11804
CA
152WC0802X
Corneal and Contact Management Optometrist
11804
CA
152WL0500X
Low Vision Rehabilitation Optometrist
11804
CA
152WP0200X
Pediatric Optometrist
11804
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410048777
RRMCARE
CA
05
—
5187135
—
CA
01
—
RR3046
RR MEDICARE
CA
05
—
SD0118040
—
CA
Enumeration date
05/11/2006
Last updated
10/23/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us