Healthcare Provider Details

I. General information

NPI: 1487635702
Provider Name (Legal Business Name): ANDERSON OPTOMETRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E MAIN ST
WILLIAMSTON SC
29697-1912
US

IV. Provider business mailing address

PO BOX 547
WILLIAMSTON SC
29697-0547
US

V. Phone/Fax

Practice location:
  • Phone: 864-847-4440
  • Fax: 864-847-6060
Mailing address:
  • Phone: 864-847-4440
  • Fax: 864-847-6060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARION K WILLIAMS
Title or Position: PRESIDENT
Credential: OPTOMETRIST
Phone: 864-847-4440