Organization
JERVEY EYE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN W SHELLEY MD (PRESIDENT/MANAGING PARTNER)
(864) 458-7956
Entity
Organization
Contact information
Practice address
5 STEVENS ST STE 200, GREENVILLE, SC 29605-4528
(864) 250-6484
(864) 250-6490
Mailing address
5 STEVENS ST STE 200, GREENVILLE, SC 29605-4528
(864) 250-6484
(864) 250-6490
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
ASF-038
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9006
MEDICARE RAILROAD
SC
05
—
GP0900
—
SC
Enumeration date
12/12/2007
Last updated
09/14/2023
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