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Organization

CAROLINA CATARACT CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEAN R JACOBS MD (PRESIDENT)
(803) 788-2276
Entity
Organization

Contact information

Practice address
2240 W DEKALB ST, WALMART VISION CENTER, CAMDEN, SC 29020-2069
(803) 788-2276
Mailing address
PO BOX 23098, COLUMBIA, SC 29224-3098
(803) 788-2276

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12570
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP2752
SC
Enumeration date
09/03/2008
Last updated
09/03/2008
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