Healthcare Provider Details

I. General information

NPI: 1194713636
Provider Name (Legal Business Name): STOKES REGIONAL EYE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

367 WEST EVANS STREET
FLORENCE SC
29501-3429
US

IV. Provider business mailing address

367 WEST EVANS STREET
FLORENCE SC
29501-3429
US

V. Phone/Fax

Practice location:
  • Phone: 843-669-4156
  • Fax: 843-664-2122
Mailing address:
  • Phone: 843-669-4156
  • Fax: 843-664-2122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK R STOKES
Title or Position: PRESIDENT/MANAGING PARTNER
Credential: MD
Phone: 843-669-4156