Provider Demographics
NPI:1770749483
Name:SMITH, ALESHA SPELLMAN (OD)
Entity type:Individual
Prefix:
First Name:ALESHA
Middle Name:SPELLMAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ALESHA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1208 KILLINGTON SQ
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-8244
Mailing Address - Country:US
Mailing Address - Phone:757-553-6400
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708
Practice Address - Country:US
Practice Address - Phone:757-953-6486
Practice Address - Fax:757-953-6487
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00672200152W00000X
MDTA2109152W00000X
VA0618001770152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist