Organization
SMOOT EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE LYNN SMOOT O.D. (OPTOMETRIST)
(812) 583-9203
Entity
Organization
Contact information
Practice address
1515 K ST, BEDFORD, IN 47421-3723
(812) 675-4199
(812) 675-0301
Mailing address
1515 K ST, BEDFORD, IN 47421-3723
(812) 675-4199
(812) 675-0301
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003555A
IN
152WP0200X
Pediatric Optometrist
18003555A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200985290A
—
IN
Enumeration date
06/21/2010
Last updated
05/19/2015
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