Organization
COASTAL EYE GROUP, P.C..
Active
Parent organization
COASTAL EYE GROUP, P.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
COASTAL EYE GROUP, P.C.
Authorized official
DR. FRANK KEENAN SLOAN JR. M.D. (PRESIDENT)
(843) 449-7115
Entity
Organization
Contact information
Practice address
123 EPPS ST, LAKE CITY, SC 29560-2449
(843) 374-5487
(843) 374-7342
Mailing address
123 EPPS ST, LAKE CITY, SC 29560-2449
(843) 374-5487
(843) 374-7342
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
495
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0281
MC PTAN
SC
05
—
D04957
—
SC
Enumeration date
10/05/2010
Last updated
10/05/2010
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