MEDICARE: STOKES REGIONAL EYE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316935885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STOKES REGIONAL EYE CENTER

Provider Business Mailing Address
First Line	:	PO BOX 100534
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29501-0534
Country	:	US
Telephone Number	:	843-669-4156
Fax Number	:	843-664-0962

Provider Business Practice Location Address
First Line	:	115 N MATTHEWS RD
Second Line	:
City	:	LAKE CITY
State	:	SC
Zip	:	29560-2309
Country	:	US
Telephone Number	:	843-394-2476
Fax Number	:	843-394-5789

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	ISAM J ZAKHOUR
Credential	:	M.D.
Telephone Number	:	843-669-4156

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	08/22/2020

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Directions to “STOKES REGIONAL EYE CENTER ” Practice Location

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