Healthcare Provider Details
I. General information
NPI: 1639141930
Provider Name (Legal Business Name): WILLIAM W SPEARMAN O.D., P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/02/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
306 E MAIN ST
PICKENS SC
29671-2385
US
IV. Provider business mailing address
306 E MAIN ST
PICKENS SC
29671-2385
US
V. Phone/Fax
- Phone: 864-878-6060
- Fax: 864-878-6275
- Phone: 864-878-6060
- Fax: 864-878-6275
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: