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Individual

DR. ALAN RICHARD SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2100 12TH AVE RD, NAMPA, ID 83686-6441
(208) 467-5293
(208) 467-5359
Mailing address
2583 N MIRANDA AVE, MERIDIAN, ID 83642-9051
(208) 895-0831

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
ODP-1060
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010148906
REGENCE
ID
01
15392
SPECTERA
ID
01
V5228
BLUE CROSS
ID
Enumeration date
08/22/2006
Last updated
07/08/2007
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