Individual
DR. JEFFREY E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
13855 ROUND LAKE BLVD NW, ANDOVER, MN 55304-3664
(763) 421-0141
(763) 421-0334
Mailing address
13855 ROUND LAKE BLVD NW, ANDOVER, MN 55304-3664
(763) 421-0141
(763) 421-0334
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1554
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114915
UCARE
MN
01
—
16125
HEALTH PARTNERS
MN
01
—
2215383
MEDICA
FM
05
—
56582330
—
MN
01
—
59780AN
BCBS
MN
01
—
747001
PREFERREDONE
MN
Enumeration date
12/08/2006
Last updated
07/08/2007
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