Individual
ALAN CHARLES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1228 GOODMAN RD E STE 1, SOUTHAVEN, MS 38671-9540
(662) 349-8838
(662) 349-8875
Mailing address
1228 GOODMAN RD E STE 1, SOUTHAVEN, MS 38671-9540
(662) 349-8838
(662) 349-8875
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
628
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087025
—
MS
Enumeration date
10/24/2006
Last updated
04/18/2008
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