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Organization

PIEDMONT RETINA ASSOC., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NICK J MCLANE M.D. (PRESIDENT)
(864) 232-1636
Entity
Organization

Contact information

Practice address
317 SAINT FRANCIS DR, SUITE 330, GREENVILLE, SC 29601-3965
(864) 232-1636
(864) 232-8695
Mailing address
317 SAINT FRANCIS DR, SUITE 330, GREENVILLE, SC 29601-3965
(864) 232-1636
(864) 232-8695

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
10329
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP0198
SC
Enumeration date
07/31/2007
Last updated
07/31/2007
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