Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 304 3rd Ave, Osceola, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578865747 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | WI2728 (Wisconsin) | Primary |
Provider Name | Brian D Smith |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1366483612 PECOS PAC ID: 7719979046 Enrollment ID: I20040330000742 |
Provider Name | April D Svoboda Smith |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1861464307 PECOS PAC ID: 0143212464 Enrollment ID: I20040402000594 |
Mailing Address | Practice Location Address |
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Po Box 386, Osceola, WI 54020-0386 Ph: (715) 294-2500 | 304 3rd Ave, Osceola, WI 54020 Ph: (715) 294-2500 |