Organization
SOUTHERN EYE OPTICAL LLC
Active
Parent organization
SOUTHERN EYE ASSOCIATES SOLE MBR
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN EYE ASSOCIATES SOLE MBR
Authorized official
DR. BRADLEY B WILLIAMS MD (PRESIDENT)
(864) 220-0737
Entity
Organization
Contact information
Practice address
100 PHYSICIANS DR, GREER, SC 29650-2445
(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
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7368890002
MEDICARE DMER
SC
Enumeration date
02/18/2015
Last updated
08/25/2015
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