Individual
DR. JEFFREY ALAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
18325 N ALLIED WAY STE 100, PHOENIX, AZ 85054
(602) 467-4966
(480) 419-5401
Mailing address
18325 N ALLIED WAY STE 100, PHOENIX, AZ 85054-3106
(602) 467-4966
(480) 419-5401
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1612
KS
152W00000X
Optometrist
2208
AZ
152W00000X
Optometrist
T03157
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2208
OPTOMETRY
AZ
01
—
410049327
RAILROAD MEDICARE
—
Enumeration date
08/23/2005
Last updated
06/12/2018
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