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Individual

DR. WILLIE DARRELL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1357 S MAIN ST, ADRIAN, MI 49221-4352
(517) 263-0424
(517) 263-6379
Mailing address
1357 S MAIN ST, ADRIAN, MI 49221-4352
(517) 263-0424
(517) 263-6379

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
490100002985
MI
152WC0802X
Corneal and Contact Management Optometrist
490100002985
MI
152WL0500X
Low Vision Rehabilitation Optometrist
490100002985
MI
152WX0102X
Occupational Vision Optometrist
490100002985
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4248362
MI
05
PH15592
MI
Enumeration date
02/27/2007
Last updated
12/05/2016
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