Smith, Elven Conrad
Smith, Elven Conrad is an sole proprietor health care provider with primary practice located at 720 E Us Highway 74 Ste A, Rockingham NC 28379-7524. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Low Vision Rehabilitation is his primary health care specialty. Smith, Elven Conrad can be contacted via phone (910) 205-2020.Contact Information
Primary practice address
720 E Us Highway 74 Ste A
Rockingham NC 28379-7524
Phone: (910) 205-2020
Fax: (910) 582-2030
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 1267 | North Carolina |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1267 | North Carolina |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 1182 | South Carolina |
Profile Details
| NPI number | 1215974548 |
|---|---|
| LBN Legal business name | Smith, Elven Conrad |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 2nd, 2006 |
| Last updated | Mar 17th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215974548 | NPPES |
| South Carolina | Other | 1182 | LICENSE # |
| South Carolina | Other | 1267 | LICENSE # |
| South Carolina | MEDICAID | 8909835 | LICENSE # |
| South Carolina | Other | 1267 | LICENSE # |
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