Individual
DR. MICHAEL L SMOOKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 STATE ST, BOSTON, MA 02109-2908
(617) 742-3937
Mailing address
101 STATE ST, BOSTON, MA 02109-2908
(617) 742-3937
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
3546
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0391921
—
MA
01
—
152798
HARVARD HEALTH PLAN
MA
01
—
732742
TUFTS HEALTH PLAN
MA
01
—
W25180
BLUE CROSS BLUE
MA
Enumeration date
02/21/2007
Last updated
07/08/2007
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