# PIEDMONT RETINA ASSOC., P.A.

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

## Provider details

- **NPI number:** 1841480399
- **Authorized official:** DR. NICK J MCLANE M.D. (PRESIDENT)
- **Authorized official phone:** (864) 232-1636

## Contact information

- **Practice address:** 317 SAINT FRANCIS DR, SUITE 330, GREENVILLE, SC 29601-3965
- **Practice address phone:** (864) 232-1636
- **Practice address fax:** (864) 232-8695
- **Mailing address:** 317 SAINT FRANCIS DR, SUITE 330, GREENVILLE, SC 29601-3965
- **Mailing address phone:** (864) 232-1636
- **Mailing address fax:** (864) 232-8695

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 10329 | SC | Yes |

## Other

- **Enumeration date:** 07/31/2007
- **Last updated:** 07/31/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP0198 | — | SC |