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Individual

DR. THOMAS W SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
601 HALTON RD, GREENVILLE, SC 29607-3403
(864) 458-7956
(864) 458-8390
Mailing address
601 HALTON RD, GREENVILLE, SC 29607-3403
(864) 458-7956
(864) 458-8390

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
646
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410024409
MEDICARE RAILROAD
SC
01
4489627
AETNA PROVIDER NUMBER
SC
01
5812847002
CIGNA PROVIDER NUMBER
SC
05
DA9938
SC
Enumeration date
01/26/2006
Last updated
06/02/2009
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