Individual
JOHN R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., M.S.
Contact information
Practice address
260 STATE ST, HAMBURG, PA 19526-1823
(610) 562-4548
(610) 562-1358
Mailing address
260 STATE ST, HAMBURG, PA 19526-1823
(610) 562-4548
(610) 562-1358
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
OEG000269
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50003676
BLUE CROSS
PA
01
—
679971
BLUE SHIELD
PA
Enumeration date
06/15/2006
Last updated
03/17/2008
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