Individual
WALTER SMITHWICK IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2535 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4710
(904) 388-6548
(904) 389-8157
Mailing address
2535 RIVERSIDE AVENUE, JACKSONVILLE, FL 32204-4710
(904) 388-6548
(904) 389-8157
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
75330
FL
207W00000X
Ophthalmology Physician
Primary
ME75330
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000895199B
—
GA
05
—
2547864-00
—
FL
Enumeration date
02/03/2006
Last updated
01/16/2019
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