Healthcare Provider Details

I. General information

NPI: 1770567505
Provider Name (Legal Business Name): FREEMAN EDWARD HUSKEY JR. OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 D AVE
WEST COLUMBIA SC
29169-6307
US

IV. Provider business mailing address

1235 D AVE
WEST COLUMBIA SC
29169-6307
US

V. Phone/Fax

Practice location:
  • Phone: 803-796-3646
  • Fax:
Mailing address:
  • Phone: 803-796-3646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number593
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: