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General NPI Number Information
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NPI Number | 1003011446
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Entity Type | Organization
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Legal Business Name | BAXTER J. SMITH JR., OD, PA
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Dates
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Enumeration Date | 06/17/2007
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 5960 FAIRVIEW RD STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28210-0202
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Country | US
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Telephone | 888-964-6681
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Fax | 888-662-0859
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Provider Business Mailing Address
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Address Line | 100 CROSSING BLVD STE 300
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City | FRAMINGHAM
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State | MA
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Zip | 01702-5555
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Country | US
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Telephone | 888-964-6681
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Fax | 339-686-2561
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BAXTER J. SMITH JR.
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Credential | OD
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Telephone | 857-255-0486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 858
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License Number State | NC
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