Individual
DR. JONATHAN HAROLD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10840 LINCOLN TRL, FAIRVIEW HEIGHTS, IL 62208-2010
(618) 397-8880
Mailing address
997 PRESTONWOOD DR, EDWARDSVILLE, IL 62025-4138
(618) 659-0297
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010386
IL
Other
Enumeration date
07/26/2010
Last updated
07/26/2010
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