Smith, Willie Darrell
Smith, Willie Darrell is an individual health care provider with primary practice located at 1357 S Main St , Adrian MI 49221-4352. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Smith, Willie Darrell can be contacted via phone (517) 263-0424.Contact Information
Primary practice address
1357 S Main St
Adrian MI 49221-4352
Phone: (517) 263-0424
Fax: (517) 263-6379
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 490100002985 | Michigan |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 490100002985 | Michigan |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 490100002985 | Michigan |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | 490100002985 | Michigan |
Profile Details
| NPI number | 1437286713 |
|---|---|
| LBN Legal business name | Smith, Willie Darrell |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Dec 5th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437286713 | NPPES |
| Michigan | MEDICAID | 4248362 | |
| Michigan | MEDICAID | PH15592 |
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