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General NPI Number Information
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NPI Number | 1972640522
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Entity Type | Individual
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Provider Name | JAMES STEVEN SMITH O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3401 S HWY 41 SUITE A1
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City | TERRE HAUTE
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State | IN
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Zip | 47802
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Country | US
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Telephone | 812-232-7461
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Fax |
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Provider Business Mailing Address
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Address Line | 4006 GOLF BAG LN
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City | TERRE HAUTE
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State | IN
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Zip | 47802-8146
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Country | US
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Telephone | 812-299-3434
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Fax |
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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 | 18001533
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License Number State | IN
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