Smith, Gary Locke
Smith, Gary Locke is an sole proprietor health care provider with primary practice located at 1013 N 5Th Ave Ne Suite 4, Rome GA 30165-2664. He recently has 7 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Smith, Gary Locke can be contacted via phone (706) 232-6767.Contact Information
Primary practice address
1013 N 5Th Ave Ne Suite 4
Rome GA 30165-2664
Phone: (706) 232-6767
Fax: (706) 291-4677
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 000687 | Georgia |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 000687 | Georgia |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 000687 | Georgia |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 000687 | Georgia |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | 000687 | Georgia |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 000687 | Georgia |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 000687 | Georgia |
Profile Details
| NPI number | 1720128572 |
|---|---|
| LBN Legal business name | Smith, Gary Locke |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2007 |
| Last updated | Mar 7th, 2023 - about 3 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 | 1720128572 | NPPES |
| Georgia | Other | 581444484 | FEDERAL ID |
| Georgia | MEDICAID | 000004727 | FEDERAL ID |
| Georgia | Other | GA000687 | FEDERAL ID |
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