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Individual

MARK P SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
6600 WHITTLESEY BLVD BLDG A, COLUMBUS, GA 31909-7337
(706) 323-3491
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-8575
(864) 359-1308
(239) 496-3939

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001254
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00451162F
GA
Enumeration date
07/18/2006
Last updated
04/30/2026
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