Basic Information
| Provider Information | |||||||||
| NPI: | 1457973984 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3240 S MARION ST | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801132930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144045673 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3400 E BAYAUD AVE STE 485 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802093000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033211606 | ||||||||
| FaxNumber: | 3033210920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2020 | ||||||||
| LastUpdateDate: | 08/31/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 0003704 | CO | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.