Smith, Bradford D

Smith, Bradford D is an sole proprietor health care provider with primary practice located at 15 Western Ave Suite 1, Augusta ME 04330-7340. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Smith, Bradford D can be contacted via phone (207) 623-2020.

Contact Information

Primary practice address
15 Western Ave Suite 1 Augusta ME 04330-7340
Phone: (207) 623-2020
Fax: (207) 623-1399
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT693 Maine

Profile Details

NPI number 1992711840
LBN Legal business name Smith, Bradford D
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Aug 14th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992711840 NPPES
Maine Other 092002183 FED BC
Maine Other MNT692 FED BC
Maine Other 2119511 FED BC
Maine MEDICAID 115000000 FED BC
Maine Other PR92498370001 FED BC
Maine Other 410019231 FED BC

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