Organization
EAST COAST RETINA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN J PHILLIPS M.D. (MEDICAL DIRECTOR)
(843) 215-3363
Entity
Organization
Contact information
Practice address
8609 MONTAGUE LN, MYRTLE BEACH, SC 29588-4504
(843) 215-3363
(843) 215-7201
Mailing address
8609 MONTAGUE LN, MYRTLE BEACH, SC 29588-4504
(843) 215-3363
(843) 215-7201
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
26821
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4339
—
SC
Enumeration date
05/10/2006
Last updated
09/26/2011
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