Individual
DR. JEREMY PATRICK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
227 E BLACKSTOCK RD, SUITE 200, SPARTANBURG, SC 29301-2632
(864) 585-7807
(864) 585-8272
Mailing address
118 MUSGROVE ST, CLINTON, SC 29325-2350
(864) 833-5555
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1321
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA05988525
PROVIDER ID NUMBER
SC
05
—
D13215
—
SC
Enumeration date
04/06/2006
Last updated
05/19/2008
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