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Individual

LLOYD W NETHERCUTT JR.

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
701 BULTMAN DRIVE, SUMTER, SC 29150
(803) 773-4723
(803) 775-5211
Mailing address
PO BOX 5721, COLUMBIA, SC 29250
(803) 779-2273
(803) 799-0854

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
615
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20005987
SELECT HEALTH OF SC
SC
05
D06152
SC
Enumeration date
06/22/2006
Last updated
07/08/2007
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