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Organization

THOMAS J. HAVILAND, OD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS J. HAVILAND O.D. (PRESIDENT)
(864) 579-2015
Entity
Organization

Contact information

Practice address
2151 E. MAIN ST., SPARTANBURG, SC 29307-1441
(864) 579-2015
Mailing address
813 MONTCLAIR CT., SPARTANBURG, SC 29301-5348
(864) 579-2015

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
775
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D07758
SC
Enumeration date
11/08/2012
Last updated
02/21/2013
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