Provider Demographics
NPI:1689750648
Name:SMITH, BAXTER J JR (OD)
Entity Type:Individual
Prefix:DR
First Name:BAXTER
Middle Name:J
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:OD
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Mailing Address - Street 1:100 CROSSING BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5555
Mailing Address - Country:US
Mailing Address - Phone:888-964-6681
Mailing Address - Fax:339-686-2561
Practice Address - Street 1:5960 FAIRVIEW RD STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-0202
Practice Address - Country:US
Practice Address - Phone:888-964-6681
Practice Address - Fax:888-662-0859
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2021-07-14
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Provider Licenses
StateLicense IDTaxonomies
NC858152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist