Provider Demographics
NPI:1336129683
Name:SMITH, FURMAN M (OD)
Entity Type:Individual
Prefix:DR
First Name:FURMAN
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:966 HOUSTON NORTHCUTT BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3487
Mailing Address - Country:US
Mailing Address - Phone:843-881-2492
Mailing Address - Fax:843-881-3192
Practice Address - Street 1:966 HOUSTON NORTHCUTT BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3487
Practice Address - Country:US
Practice Address - Phone:843-881-2492
Practice Address - Fax:843-881-3192
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC583152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD05830Medicaid
SC570725077OtherPROVIDER ID #