Individual
MARLON G BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
90 CEDAR LIGHT LN, LITTLE RIVER, SC 29566-6978
(843) 280-8779
(843) 280-6669
Mailing address
90 CEDAR LIGHT LN, LITTLE RIVER, SC 29566-6978
(843) 280-8779
(843) 280-8779
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2374
SC
152W00000X
Optometrist
OEG001552
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1232505
CIGNA
—
01
—
2374
STATE LICENSE
SC
01
—
250197
HEALTH ASSURANCE
—
01
—
50041186
CAPITOL BLUE
—
01
—
BU904393
BLUE S
—
05
—
D23749
—
SC
Enumeration date
11/04/2005
Last updated
02/11/2025
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