Provider Demographics
NPI:1689679946
Name:SMILEY, CHRIS A (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:A
Last Name:SMILEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 MT AIRYSHIRE BLVD.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235
Mailing Address - Country:US
Mailing Address - Phone:614-880-2020
Mailing Address - Fax:614-846-8577
Practice Address - Street 1:730 MT AIRYSHIRE BLVD.
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235
Practice Address - Country:US
Practice Address - Phone:614-880-2020
Practice Address - Fax:614-846-8577
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5241152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X, 152W00000X, 152WC0802X
OHOPT.005241152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4051962Medicare PIN
OHU85239Medicare UPIN
OH4051961Medicare PIN