Organization
RIDGELAND EYE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK T GOULAS MD (PARTNER)
(843) 757-9661
Entity
Organization
Contact information
Practice address
10668 SOUTH JACOB SMART BOULEVARD, RIDGELAND, SC 29936
(843) 757-9661
Mailing address
10668 SOUTH JACOB SMART BOULEVARD, RIDGELAND, SC 29936
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
1335
SC
207W00000X
Ophthalmology Physician
1344
SC
207W00000X
Ophthalmology Physician
Primary
22573
SC
207W00000X
Ophthalmology Physician
26698
SC
208200000X
Plastic Surgery Physician
22573
SC
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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