Healthcare Provider Details

I. General information

NPI: 1922070234
Provider Name (Legal Business Name): WILLIAM W. SPEARMAN O.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 04/15/2008
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

Practice location:
  • Phone: 864-878-6060
  • Fax: 864-878-6272
Mailing address:
  • Phone: 864-878-6060
  • Fax: 864-878-6272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number039165688
License Number StateSC

VIII. Authorized Official

Name: DREMA J LAFOY
Title or Position: BILLING SPECIALIST
Credential:
Phone: 864-878-6060