Healthcare Provider Details

I. General information

NPI: 1316935885
Provider Name (Legal Business Name): STOKES REGIONAL EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N MATTHEWS RD
LAKE CITY SC
29560-2309
US

IV. Provider business mailing address

PO BOX 100534
FLORENCE SC
29501-0534
US

V. Phone/Fax

Practice location:
  • Phone: 843-394-2476
  • Fax: 843-394-5789
Mailing address:
  • Phone: 843-669-4156
  • Fax: 843-664-0962

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ISAM J ZAKHOUR
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 843-669-4156