Individual
DR. ELVEN CONRAD SMITH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
720 E US HIGHWAY 74, STE A, ROCKINGHAM, NC 28379-7524
(910) 205-2020
(910) 582-2030
Mailing address
1502 E BROAD AVE, STE A, ROCKINGHAM, NC 28379-4908
(910) 997-7737
(910) 997-7058
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1267
NC
152WL0500X
Low Vision Rehabilitation Optometrist
1182
SC
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
1267
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1182
LICENSE #
SC
01
—
1267
LICENSE#
NC
05
—
8909835
—
NC
Enumeration date
06/02/2006
Last updated
03/17/2021
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