Organization
YUCHONG SMITH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YUCHONG SMITH O.D. (OWNER)
(770) 577-5268
Entity
Organization
Contact information
Practice address
6580 DOUGLAS BLVD, DOUGLASVILLE, GA 30135-1507
(770) 577-5268
(770) 577-2528
Mailing address
1905 BENNETTS POINT DR., MARIETTA, GA 30068
(770) 577-5268
(770) 577-2528
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1650
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00308229
RAIL ROAD MEDICARE
GA
Enumeration date
04/11/2007
Last updated
10/18/2012
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