Organization
EASTSIDE EYE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE E ROEL MD (OWNER)
(864) 542-1308
Entity
Organization
Contact information
Practice address
735 E MAIN ST, SPARTANBURG, SC 29302-1281
(864) 542-1308
Mailing address
735 E MAIN ST, SPARTANBURG, SC 29302-1281
(864) 542-1308
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14463
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2757
—
SC
Enumeration date
09/25/2006
Last updated
10/24/2007
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