Individual
DR. DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0DT640
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0736630001
PTAN
TN
Enumeration date
02/27/2007
Last updated
05/14/2014
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