Individual
DR. JACOB CONNOR SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
110 COLLEGE ST STE B, ATHENS, AL 35611-2714
(256) 233-5454
Mailing address
20189 MARY ELLA ST, TANNER, AL 35671-3645
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-E40
AL
Other
Enumeration date
06/05/2020
Last updated
06/05/2020
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