Smith, Cory W

Smith, Cory W is an individual health care provider with primary practice located at 27 Montebello Rd , Pueblo CO 81001-1236. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Smith, Cory W can be contacted via phone (719) 545-1530.

Contact Information

Primary practice address
27 Montebello Rd Pueblo CO 81001-1236
Phone: (719) 545-1530
Fax: (719) 545-2899
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2379 Colorado

Profile Details

NPI number 1073563573
LBN Legal business name Smith, Cory W
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Dec 15th, 2014 - about 12 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 1073563573 NPPES
Colorado Other CO2379 EYEMED EYECARE
Colorado Other P00041114 EYEMED EYECARE
Colorado Other 920713020820 EYEMED EYECARE
Colorado Other SM66441 EYEMED EYECARE
Colorado Other 0452890001 EYEMED EYECARE
Colorado MEDICAID 02628384 EYEMED EYECARE
Colorado Other 608439600 EYEMED EYECARE
Colorado Other 66441 EYEMED EYECARE

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