Smith, J. Kyle
Smith, J. Kyle is an sole proprietor health care provider with primary practice located at 450 N Mcpherson St , Fort Bragg CA 95437-3314. He recently has 4 registered licenses in different health care specialties including 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 / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Smith, J. Kyle can be contacted via phone (707) 964-5927.Contact Information
Primary practice address
450 N Mcpherson St
Fort Bragg CA 95437-3314
Phone: (707) 964-5927
Fax: (707) 964-6533
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 11804 | California |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 11804 | California |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 11804 | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 11804 | California |
Profile Details
| NPI number | 1184674152 |
|---|---|
| LBN Legal business name | Smith, J. Kyle |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2006 |
| Last updated | Oct 23rd, 2023 - about 2 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 | 1184674152 | NPPES |
| California | Other | 410048777 | RRMCARE |
| California | Other | RR3046 | RRMCARE |
| California | MEDICAID | SD0118040 | RRMCARE |
| California | MEDICAID | 5187135 | RRMCARE |
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