MEDICARE: DR. TODD R. SMITH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1301	AZ

General Provider Information

NPI Number	:	1023003753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD R. SMITH O.D.

Provider Business Mailing Address
First Line	:	8877 W UNION HILLS DR
Second Line	:	STE 460
City	:	PEORIA
State	:	AZ
Zip	:	85382-3008
Country	:	US
Telephone Number	:	623-256-0400
Fax Number	:	623-376-6800

Provider Business Practice Location Address
First Line	:	8877 W UNION HILLS DR
Second Line	:	STE 460
City	:	PEORIA
State	:	AZ
Zip	:	85382-3008
Country	:	US
Telephone Number	:	623-256-0400
Fax Number	:	623-376-6800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	05/15/2013

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Directions to “ DR. TODD R. SMITH O.D.” Practice Location

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