Individual
JEFFERY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5530 N PORT WASHINGTON RD, MILWAUKEE, WI 53217-4920
(414) 332-1114
(414) 332-5169
Mailing address
11103 WEST AVE, SUITE 6, SAN ANTONIO, TX 78213-1370
(210) 524-6663
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1980-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38575900
—
WI
Enumeration date
12/28/2006
Last updated
07/09/2007
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