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Individual

ZACK C CLARKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1513 GREGG ST, COLUMBIA, SC 29201-3529
(803) 254-4951
(803) 254-4952
Mailing address
1513 GREGG ST, COLUMBIA, SC 29201-3529
(803) 254-4951
(803) 254-4952

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
SC534
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
047383001
DMERC
01
407540233
RAILROAD MEDICARE
05
D05340
SC
Enumeration date
08/16/2005
Last updated
07/14/2008
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