Provider Demographics
NPI:1154655587
Name:SMITH, RITCHIE HUEBERT (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:RITCHIE
Middle Name:HUEBERT
Last Name:SMITH
Suffix:
Gender:M
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 ARCARO DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-0926
Mailing Address - Country:US
Mailing Address - Phone:336-772-3327
Mailing Address - Fax:
Practice Address - Street 1:137 ARCARO DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-0926
Practice Address - Country:US
Practice Address - Phone:336-772-3327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1144156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician