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Organization
SOUTHERN EYE ASSOCIATES OF SOUTH CAROLINA, PA
Active
Organization
SOUTHERN EYE ASSOCIATES OF SOUTH CAROLINA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA RENEE BAILEY (PRACTICE MANAGER)
(642) 220-0737
Entity
Organization
Contact information
Practice address
113 DOCTORS DR, GREENVILLE, SC 29605-5608
(864) 269-3333
(864) 295-1288
Mailing address
113 DOCTORS DR, GREENVILLE, SC 29605-5608
(864) 269-3333
(864) 295-1288
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053369777
NPI
SC
01
—
1205122975
NPI
MO
01
—
1295886125
NPI
SC
05
—
130735
—
SC
01
—
1396841599
NPI
SC
01
—
1437107836
NPI
SC
05
—
153549
—
SC
01
—
1548218340
NPI
SC
01
—
1571
MEDICARE GROUP GREENVILLE OFFICE NUMBER
SC
01
—
1639127046
NPI
SC
01
—
1760431035
NPI
SC
01
—
1821439878
NPI
SC
05
—
335998
—
SC
05
—
52668
—
SC
01
—
6180
MEDICARE GROUP NUMBER GREER OFFICE
SC
05
—
D17998
—
SC
05
—
DA9608
—
SC
05
—
GP2766
—
SC
05
—
PA6449
—
SC
05
—
T48026
—
SC
05
—
TL5190
—
SC
Enumeration date
06/22/2005
Last updated
04/20/2018
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