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General NPI Number Information
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NPI Number | 1881850402
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Entity Type | Individual
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Provider Name | CHRISTOPHER ALLEN SMITH O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/03/2008
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 2422 W CENTRAL AVE SUITE C
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City | EL DORADO
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State | KS
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Zip | 67042-3239
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Country | US
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Telephone | 316-452-5999
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Fax | 316-452-5624
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Provider Business Mailing Address
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Address Line | 8501 W CANDLEWOOD ST
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City | WICHITA
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State | KS
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Zip | 67205-8617
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Country | US
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Telephone | 316-708-9992
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Fax | 316-452-5624
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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 | 1826
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License Number State | KS
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