# JERVEY EYE GROUP, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396044236
- **Authorized official:** LISA L FARMER (SURGERY CENTER DIRECTOR)
- **Authorized official phone:** (864) 250-6484

## Contact information

- **Practice address:** 601 HALTON RD, GREENVILLE, SC 29607-3403
- **Practice address phone:** (864) 458-7956
- **Practice address fax:** (864) 458-8390
- **Mailing address:** 601 HALTON RD, GREENVILLE, SC 29607-3403
- **Mailing address phone:** (864) 458-7956
- **Mailing address fax:** (864) 458-8390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 11002 | SC | Yes |
| 207W00000X | Ophthalmology Physician | 24224 | SC | — |
| 207W00000X | Ophthalmology Physician | 26913 | SC | — |
| 207W00000X | Ophthalmology Physician | 291 | SC | — |
| 207W00000X | Ophthalmology Physician | 7319 | SC | — |
| 207W00000X | Ophthalmology Physician | 8984 | SC | — |

## Other

- **Enumeration date:** 03/17/2011
- **Last updated:** 11/13/2019