Provider Demographics
NPI:1952190712
Name:SMITH VALLEY VISION LLC
Entity type:Organization
Organization Name:SMITH VALLEY VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BENSON
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:920-205-3844
Mailing Address - Street 1:725 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-5859
Mailing Address - Country:US
Mailing Address - Phone:920-205-3844
Mailing Address - Fax:928-775-6292
Practice Address - Street 1:3450 N GLASSFORD HILL RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1351
Practice Address - Country:US
Practice Address - Phone:928-499-3152
Practice Address - Fax:928-775-6292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier