Organization
PAUL W DERRICK, OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL W DERRICK OD (OWNER)
(843) 818-2020
Entity
Organization
Contact information
Practice address
8096 RIVERS AVE STE A, NORTH CHARLESTON, SC 29406-9243
(843) 818-2020
(843) 818-2379
Mailing address
8096 RIVERS AVE STE A, NORTH CHARLESTON, SC 29406-9243
(843) 818-2020
(843) 818-2379
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
496
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D04966
—
SC
Enumeration date
04/09/2013
Last updated
04/09/2013
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