Provider Demographics
NPI:1629267794
Name:F E SMITH O D INC
Entity Type:Organization
Organization Name:F E SMITH O D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:F E
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:918-423-3043
Mailing Address - Street 1:PO BOX 1045
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74502-1045
Mailing Address - Country:US
Mailing Address - Phone:918-423-3043
Mailing Address - Fax:918-420-5705
Practice Address - Street 1:401 E CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5333
Practice Address - Country:US
Practice Address - Phone:918-423-3043
Practice Address - Fax:918-420-5705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========001OtherBCBS
OK=========001OtherBCBS