Provider Demographics
NPI:1235443920
Name:SMART, COLE PAXTON (OD)
Entity Type:Individual
Prefix:
First Name:COLE
Middle Name:PAXTON
Last Name:SMART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19705 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-3350
Mailing Address - Country:US
Mailing Address - Phone:913-706-2318
Mailing Address - Fax:
Practice Address - Street 1:1501 SW WANAMAKER RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3803
Practice Address - Country:US
Practice Address - Phone:785-272-3782
Practice Address - Fax:785-272-2684
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010022260152W00000X
KS1879152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist