Provider Demographics
NPI:1932213741
Name:SMITH, WILLIAM C II (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:SMITH
Suffix:II
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SOUTH ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3701
Mailing Address - Country:US
Mailing Address - Phone:615-893-1913
Mailing Address - Fax:615-893-1917
Practice Address - Street 1:119 SOUTH ACADEMY ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3701
Practice Address - Country:US
Practice Address - Phone:615-893-1913
Practice Address - Fax:615-893-1917
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT737152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2000958OtherTENNCARE SELECT
TN7373989OtherCIGNA
TN2000958OtherBLUECROSS BLUESHIELD TN
TN7373989OtherCIGNA
TN2000958OtherBLUECROSS BLUESHIELD TN
TNT61220Medicare UPIN