Healthcare Provider Details

I. General information

NPI: 1982520086
Provider Name (Legal Business Name): GRIFFIN EYE SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MEDICAL CIR
MYRTLE BEACH SC
29572-4114
US

IV. Provider business mailing address

900 MEDICAL CIR
MYRTLE BEACH SC
29572-4114
US

V. Phone/Fax

Practice location:
  • Phone: 843-449-6414
  • Fax: 843-449-7614
Mailing address:
  • Phone: 843-449-6414
  • Fax: 843-449-7614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID PREVATT
Title or Position: ADMINISTRATOR
Credential: BSN, RN
Phone: 843-449-6414