Individual
MATTHEW T SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1265 E PRIMROSE ST, SPRINGFIELD, MO 65804-4278
(417) 886-3937
(417) 886-1285
Mailing address
1265 E PRIMROSE ST, SPRINGFIELD, MO 65804-4278
(417) 886-3937
(417) 886-1285
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2001017859
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213429209
—
MO
05
—
315429217
—
MO
Enumeration date
03/16/2006
Last updated
06/23/2020
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