Individual
DR. MITCHELL G SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1601 E 81ST AVE, MERRILLVILLE, IN 46410
(219) 750-9673
Mailing address
6280 W. MAIN ST., APT. 112, PORTAGE, IN 46368
(219) 851-4637
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004117A
IN
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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