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Individual

DR. PHILIP DUNNE FLYNN IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2757 LAUREL ST, COLUMBIA, SC 29204-2037
(803) 799-7358
(803) 779-3719
Mailing address
2757 LAUREL ST, COLUMBIA, SC 29204-2037
(803) 799-7358
(803) 779-3719

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1250
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0239370001
DMEPO
SC
05
D12500
SC
01
U91386
NSC
SC
Enumeration date
03/14/2006
Last updated
09/08/2008
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