Individual
DR. ALEX JONATHAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1920 E. BASELINE ROAD, TEMPE, AZ 85283
(480) 345-5085
(408) 345-5266
Mailing address
25500 N. NORTERRA PARKWAY, BLDG B, PHOENIX, AZ 85085
(623) 277-1000
(602) 906-2789
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1570
AZ
152WP0200X
Pediatric Optometrist
1570
AZ
152WV0400X
Vision Therapy Optometrist
1570
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2032233
—
WA
05
—
240471
—
OR
Enumeration date
05/18/2006
Last updated
03/28/2014
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