Individual
KIMBERLY D SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
245 N MAIN ST, STE 300, SPRINGBORO, OH 45066-9171
(937) 748-2955
Mailing address
6441 EDGEBROOK CT, MASON, OH 45040
(513) 459-9495
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4594
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9348121
GROUP MEDICARE PIN
OH
Enumeration date
02/08/2007
Last updated
03/14/2008
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