Provider Demographics
NPI:1043617285
Name:SMITH, CARRIE E (OD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
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:PO BOX 59449
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35259-9449
Mailing Address - Country:US
Mailing Address - Phone:205-876-8988
Mailing Address - Fax:205-679-8440
Practice Address - Street 1:2010 PATTON CHAPEL RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-5782
Practice Address - Country:US
Practice Address - Phone:205-876-8988
Practice Address - Fax:205-679-8440
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-D32-TA-A08152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist