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General NPI Number Information
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NPI Number | 1184674590
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Entity Type | Individual
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Provider Name | JASON LOWELL SMOTHERS OD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 08/09/2019
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Provider Practice Location Address
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Address Line | 1100 S DUPREE AVE
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City | BROWNSVILLE
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State | TN
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Zip | 38012
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Country | US
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Telephone | 731-772-0101
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Fax | 731-772-2604
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Provider Business Mailing Address
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Address Line | PO BOX 110
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City | GADSDEN
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State | TN
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Zip | 38337-0110
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Country | US
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Telephone | 731-784-4058
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Fax | 731-772-2604
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TN17651795
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License Number State | TN
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