Organization
DRS STEVEN AND BRENDA SMOKE OD PC
Active
Other names
Smoke Family Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA D SMOKE O.D. (VICE PRESIDENT)
(269) 469-6331
Entity
Organization
Contact information
Practice address
18301 US HIGHWAY 12, NEW BUFFALO, MI 49117-8848
(269) 469-6331
(269) 469-6848
Mailing address
18301 US HIGHWAY 12, NEW BUFFALO, MI 49117-8848
(269) 469-6331
(269) 469-6848
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
04901003315
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P18480
PTAN
MI
01
—
900A10020
BCBS GROUP PIN
MI
Enumeration date
01/18/2007
Last updated
08/24/2009
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