Organization
BRANCH & STAFFORD OPTOMETRIC ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT BRANCH OD (PRESIDENT)
(803) 781-2212
Entity
Organization
Contact information
Practice address
7455 IRMO DR, COLUMBIA, SC 29212-8636
(803) 781-2212
(803) 233-2883
Mailing address
PO BOX 227, IRMO, SC 29063-0227
(803) 781-2212
(803) 233-2883
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
609,696,496,1336
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410031738
MEDICARE RAILROAD
SC
05
—
D04966
—
SC
05
—
D06090
—
CA
05
—
D06964
—
SC
05
—
PC2500
—
SC
Enumeration date
11/06/2006
Last updated
04/12/2018
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