Organization
PALMETTO EYE & LASER CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BILLY J HAGUEWOOD JR. M.D. (OWNER)
(864) 583-6381
Entity
Organization
Contact information
Practice address
1520 BOILING SPRINGS RD, BOILING SPRINGS, SC 29316-5121
(864) 583-6381
(864) 583-6390
Mailing address
479 HEYWOOD AVE, SPARTANBURG, SC 29307-1726
(864) 583-6381
(864) 583-6390
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7292
MEDICARE GROUP ID
SC
01
—
CJ6730
RAILROAD MEDICARE GROUP
SC
01
—
GP3396
MEDICAID GROUP
SC
Enumeration date
07/09/2006
Last updated
07/09/2019
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