Provider Demographics
NPI:1467645838
Name:JULIE SMITH, O.D., P.C.
Entity Type:Organization
Organization Name:JULIE SMITH, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-207-1277
Mailing Address - Street 1:301 S NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-3433
Mailing Address - Country:US
Mailing Address - Phone:256-207-1277
Mailing Address - Fax:256-207-1257
Practice Address - Street 1:301 S NORTON AVE
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-3433
Practice Address - Country:US
Practice Address - Phone:256-207-1277
Practice Address - Fax:256-207-1257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS856TA421152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALU66155Medicare UPIN