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Individual

DR. ROBERT CARL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.009880
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046009880
IL
01
0814870001
MEDICARE NSC NUMBER
IL
01
0814870028
MEDICARE NSC NUMBER
IL
01
0814870029
MEDICARE NSC NUMBER
IL
01
0814870031
MEDICARE NSC NUMBER
IL
01
133825
HEALTH ALLIANCE
01
IL9880
EYEMED
01
P00418703
MEDICARE RAILROAD
IL
Enumeration date
01/08/2007
Last updated
06/15/2021
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