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General NPI Number Information
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NPI Number | 1558728154
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Entity Type | Organization
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Legal Business Name | KRISTINA H. SMITH OD PLLC
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 314 NORTHGATE MALL
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City | CHATTANOOGA
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State | TN
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Zip | 37415-6922
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Country | US
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Telephone | 423-875-3060
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Fax | 423-877-2714
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Provider Business Mailing Address
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Address Line | 272 COTTONPORT RD
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City | DAYTON
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State | TN
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Zip | 37321-5100
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Country | US
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Telephone | 423-618-0287
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | KRISTINA HIXSON SMITH
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Credential | OD
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Telephone | 423-618-0287
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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 | TN3141
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License Number State | TN
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