Provider Demographics
NPI:1861464307
Name:SVOBODA SMITH, APRIL DAWN (OD)
Entity type:Individual
Prefix:DR
First Name:APRIL
Middle Name:DAWN
Last Name:SVOBODA SMITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:SIREN
Mailing Address - State:WI
Mailing Address - Zip Code:54872-0290
Mailing Address - Country:US
Mailing Address - Phone:715-825-3974
Mailing Address - Fax:715-349-2744
Practice Address - Street 1:24082 STATE ROAD 35
Practice Address - Street 2:
Practice Address - City:SIREN
Practice Address - State:WI
Practice Address - Zip Code:54872
Practice Address - Country:US
Practice Address - Phone:715-349-2733
Practice Address - Fax:715-349-2744
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2729152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI010724315011OtherBCBS OF WI
WI38604000Medicaid
WIC69931030008OtherPREFERRED ONE
2203121OtherMEDICA
WI2204394OtherMEDICA
MN304535VOtherBCBS OF MN
HP84006OtherHEALTH PARTNERS
WI010724315011OtherBCBS OF WI
MN304535VOtherBCBS OF MN
V74808Medicare UPIN