| NPI | 1104828946 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2005-08-11 |
| Last Updated | 2017-09-14 |
| Mailing Address | 617 S Main St Stillwater, OK 74074-4060 United States Phone: (405) 372-7337 | Fax: (405) 372-7339 📍 View Map |
| Primary Practice Address | 617 S Main St Stillwater, OK 74074-4060 United States Phone: (405) 372-7337 | Fax: (405) 372-7337 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | OK | 1000763810A | - |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 152W00000X – Optometrist | OK | 1168 |
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About NPI 1104828946
Eddie Alan Smith O.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1104828946. The primary specialty listed is Optometrist. The provider is located in Stillwater, OK. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2005-08-11. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104828946?
NPI 1104828946 belongs to Eddie Alan Smith O.D., a Optometrist in Stillwater, OK. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104828946 active?
The current status of NPI 1104828946 in the NPPES registry is Active. The record was last updated on 2017-09-14.
What specialty is NPI 1104828946?
NPI 1104828946 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104828946?
You can verify NPI 1104828946 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104828946?
The primary practice address on file for NPI 1104828946 is 617 S Main St, Stillwater, OK 74074-4060. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104828946 issued?
NPI 1104828946 was first issued (enumerated) on 2005-08-11. The NPPES record was last updated on 2017-09-14.
Practice Location Map
Eddie Alan Smith is located at 617 S Main St, Stillwater, OK. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Eddie Alan Smith. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104828946. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Optometrist | 1168 | OK |