Individual
DR. JENNIFER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2800 WALMART DR, HUNTINGTON, IN 46750-7977
(260) 355-0575
Mailing address
2800 WALMART DR, HUNTINGTON, IN 46750-7977
(260) 355-0575
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003138
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200347270A
—
IN
01
—
203751829
TAX ID
IN
Enumeration date
08/15/2006
Last updated
07/10/2024
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