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Individual

DR. RUFUS BEDFORD ANTLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
117 W CHURCH ST, BATESBURG, SC 29006-2108
(803) 532-9870
(803) 532-1259
Mailing address
117 W CHURCH ST, BATESBURG, SC 29006-2108
(803) 532-9870
(803) 532-1259

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
433
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0652760001
DMERC
SC
01
570629655-002
TRICARE
SC
05
D04332
SC
Enumeration date
10/19/2005
Last updated
02/26/2008
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