Provider Demographics
NPI:1457973984
Name:SMITH, EMILY (OD, MS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 S MARION ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2930
Mailing Address - Country:US
Mailing Address - Phone:814-404-5673
Mailing Address - Fax:
Practice Address - Street 1:3400 E BAYAUD AVE STE 485
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3000
Practice Address - Country:US
Practice Address - Phone:303-321-1606
Practice Address - Fax:303-321-0920
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003704152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist