Smith, Larry Dean
Smith, Larry Dean is an individual health care provider with primary practice located at 914 Avenue G , Fort Madison IA 52627-4530. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Smith, Larry Dean can be contacted via phone (319) 372-5181.Contact Information
Primary practice address
914 Avenue G
Fort Madison IA 52627-4530
Phone: (319) 372-5181
Fax: (319) 372-0865
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1601 | Iowa |
Profile Details
| NPI number | 1023083326 |
|---|---|
| LBN Legal business name | Smith, Larry Dean |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Oct 1st, 2007 - about 19 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 | 1023083326 | NPPES |
| Iowa | MEDICAID | 0044214 |
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