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Organization

SIEGMUND EYE CARE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON SIEGMUND OD (OWNER)
(843) 796-1155
Entity
Organization

Contact information

Practice address
4278 RIVER OAKS DR, MYRTLE BEACH, SC 29579-5603
(843) 796-1155
(843) 796-1153
Mailing address
4278 RIVER OAKS DR, MYRTLE BEACH, SC 29579-5603
(843) 796-1155
(843) 796-1153

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
SC1389
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1073675690
INDIVIDUAL NPI - JASON
SC
01
1528120144
INDIVIDUAL NPI - KELLE
SC
Enumeration date
03/19/2007
Last updated
01/28/2015
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