Organization
SCOTT SMITH OD, PLLC
Active
Other names
Family Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT SMITH OD (OWNER)
(502) 839-5113
Entity
Organization
Contact information
Practice address
500 W BROADWAY ST, LAWRENCEBURG, KY 40342-1306
(502) 839-5113
(502) 839-9831
Mailing address
PO BOX 168, LAWRENCEBURG, KY 40342-0168
(502) 839-5113
(502) 839-9831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1390DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000217614
BLUE CROSS BLUE SHIELD
KY
05
—
45004413
—
KY
05
—
77013902
—
KY
01
—
P00204906
RAIL ROAD MEDICARE
KY
Enumeration date
02/28/2008
Last updated
02/28/2008
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