Organization
DRS SMITH SMITH AND MAUS PC
Active
Other names
DR L D SMITH & DR C R SMITH PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY D SMITH OD (PRESIDENT, OPTOMETRIST)
(319) 372-5181
Entity
Organization
Contact information
Practice address
914 AVENUE G, FORT MADISON, IA 52627-4530
(319) 372-5181
Mailing address
914 AVENUE G, FORT MADISON, IA 52627-4530
(319) 372-5181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099234
—
IA
01
—
09923
MEDICARE GROUP NUMBER
IA
Enumeration date
11/26/2007
Last updated
11/26/2007
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