Provider Demographics
NPI:1881976025
Name:SMITH, JUSTIN D (OD)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:D
Last Name:SMITH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:237 W WILLOW CIR
Mailing Address - Street 2:
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040-4671
Mailing Address - Country:US
Mailing Address - Phone:205-910-8430
Mailing Address - Fax:205-982-7558
Practice Address - Street 1:3053 JOHN HAWKINS PKWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1028
Practice Address - Country:US
Practice Address - Phone:205-982-1797
Practice Address - Fax:205-982-7558
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALS-C63-TA-888152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist