Healthcare Provider Details

I. General information

NPI: 1639386832
Provider Name (Legal Business Name): STEVEN CRAIG HOBBS OD OPTOMETRIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 11/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 WEST MAIN STREET
LAKE CITY SC
29560
US

IV. Provider business mailing address

PO BOX 850 339 W MAIN
LAKE CITY SC
29560
US

V. Phone/Fax

Practice location:
  • Phone: 843-374-2040
  • Fax: 843-374-5131
Mailing address:
  • Phone: 843-374-2040
  • Fax: 843-374-5131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number561
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: