Organization
DR JOHN O SMITH OPTOMETRIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN O. SMITH O.D. (PRESIDENT)
(405) 853-6800
Entity
Organization
Contact information
Practice address
1201 S MAIN ST, HENNESSEY, OK 73742-1744
(405) 853-6800
(405) 853-6805
Mailing address
1201 S MAIN ST, HENNESSEY, OK 73742-1744
(405) 853-6800
(405) 853-6805
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1014
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100763790A
—
OK
Enumeration date
06/06/2013
Last updated
06/06/2013
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