Individual
MR. JASON LOWELL SMOTHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1100 S DUPREE AVE, BROWNSVILLE, TN 38012
(731) 772-0101
(731) 772-2604
Mailing address
PO BOX 110, GADSDEN, TN 38337-0110
(731) 784-4058
(731) 772-2604
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TN17651795
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11230090
CAQH
TN
05
—
3941117
—
TN
05
—
Q020350
—
TN
Enumeration date
05/10/2006
Last updated
08/09/2019
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