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
Fax: (706) 291-4677
Website:

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720128572 NPPES
Georgia Other 581444484 FEDERAL ID
Georgia MEDICAID 000004727 FEDERAL ID
Georgia Other GA000687 FEDERAL ID

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