Smith, Stephen Damon
Smith, Stephen Damon is an individual health care provider with primary practice located at 140 W Market St , Louisville KY 40202-1332. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Smith, Stephen Damon can be contacted via phone (502) 587-8696.Contact Information
Primary practice address
140 W Market St
Louisville KY 40202-1332
Phone: (502) 587-8696
Fax: (502) 587-8165
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002709 | Indiana |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1445 DT | Kentucky |
Profile Details
| NPI number | 1114929460 |
|---|---|
| LBN Legal business name | Smith, Stephen Damon |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| 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 | 1114929460 | NPPES |
| Kentucky | Other | 000000198612 | ANTHEM PROVIDER |
| Kentucky | Other | 918468 | ANTHEM PROVIDER |
| Kentucky | Other | 1445DT | ANTHEM PROVIDER |
| Kentucky | MEDICAID | 77340503 | ANTHEM PROVIDER |
| Kentucky | Other | 18002709 | ANTHEM PROVIDER |
| Kentucky | Other | 21434 | ANTHEM PROVIDER |
| Kentucky | Other | 11221323 | ANTHEM PROVIDER |
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