Organization
CAROLINA CATARACT AND VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CANDICE DAVIS (CHIEF REVENUE CYCLE OFFICER)
(916) 990-7590
Entity
Organization
Contact information
Practice address
137 GATEWAY DRIVE, LADSON, SC 29456-3552
(843) 797-3676
(843) 797-3677
Mailing address
PO BOX 279, LADSON, SC 29456-0279
(843) 797-3676
(843) 797-3677
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
18651
SC
207W00000X
Ophthalmology Physician
Primary
21896
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073562492
INDIVIDUAL NPI
SC
01
—
1750393138
INDIVIDUAL NPI
SC
05
—
1D218963
—
SC
01
—
P00371766
RAILROAD MEDICARE
SC
Enumeration date
02/27/2008
Last updated
11/17/2023
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