Provider Demographics
NPI:1134557358
Name:SMITH'S FAMILY EYE CARE
Entity type:Organization
Organization Name:SMITH'S FAMILY EYE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:517-849-9277
Mailing Address - Street 1:461 OLDS ST
Mailing Address - Street 2:PO BOX 129
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-9433
Mailing Address - Country:US
Mailing Address - Phone:517-849-9277
Mailing Address - Fax:517-849-2134
Practice Address - Street 1:461 OLDS ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:MI
Practice Address - Zip Code:49250-9433
Practice Address - Country:US
Practice Address - Phone:517-849-9277
Practice Address - Fax:517-849-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty