Individual
EMMETT DONALD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
136 NORTH ST, CLEVELAND, MS 38732-2744
(662) 846-6641
(662) 846-6644
Mailing address
PO BOX 1108, CLEVELAND, MS 38732-1108
(662) 846-6641
(662) 846-6644
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
546
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09957099
—
MS
Enumeration date
10/14/2005
Last updated
12/30/2009
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