Healthcare Provider Details

I. General information

NPI: 1588752240
Provider Name (Legal Business Name): LOW COUNTRY EYE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 PLANTATION PARK DR SUITE 401
BLUFFTON SC
29910-6038
US

IV. Provider business mailing address

23 PLANTATION PARK DR SUITE 401
BLUFFTON SC
29910-6038
US

V. Phone/Fax

Practice location:
  • Phone: 843-815-7222
  • Fax: 843-815-7201
Mailing address:
  • Phone: 843-815-7222
  • Fax: 843-815-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number26698
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number26698
License Number StateSC

VIII. Authorized Official

Name: DAVID J REMIGIO
Title or Position: OWNER
Credential: M.D.
Phone: 843-815-7222