Individual
DR. GREGORY MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3259 CATLIN AVE, NAVAL MEDICAL CLINIC QUANTICO, QUANTICO, VA 22134
(703) 784-1634
(703) 784-1635
Mailing address
1 HICKORY RIDGE DR, FREDERICKSBURG, VA 22405-1402
(215) 850-7892
(703) 784-1635
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001601
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1880196
UNITED STATES NAVY
VA
Enumeration date
08/14/2006
Last updated
07/08/2007
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