Healthcare Provider Details

I. General information

NPI: 1508921495
Provider Name (Legal Business Name): JEFFREY R GEER OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4592 JEFFERSON DAVIS HWY
BEECH ISLAND SC
29842-4872
US

IV. Provider business mailing address

PO BOX 280
CLEARWATER SC
29822-0280
US

V. Phone/Fax

Practice location:
  • Phone: 803-593-4508
  • Fax: 803-593-4504
Mailing address:
  • Phone: 803-593-4508
  • Fax: 803-593-4504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number974
License Number StateSC

VIII. Authorized Official

Name: JEFFREY ROBERT GEER
Title or Position: OWNER
Credential: OD
Phone: 803-593-4508