Provider Demographics
NPI:1043617285
Name:SMITH, CARRIE ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1716 UNIVERSITY BLVD
Mailing Address - Street 2:HPB G080A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0010
Mailing Address - Country:US
Mailing Address - Phone:205-975-2020
Mailing Address - Fax:205-934-6755
Practice Address - Street 1:535 JACK WARNER PKWY NE STE B1
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5715
Practice Address - Country:US
Practice Address - Phone:205-556-2121
Practice Address - Fax:205-554-0152
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-D32-TA-A08152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist