Healthcare Provider Details

I. General information

NPI: 1396720017
Provider Name (Legal Business Name): WILLIAM C OLIVER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 N CONGRESS ST
YORK SC
29745-1529
US

IV. Provider business mailing address

46 N WILSON ST
ROCK HILL SC
29730-4050
US

V. Phone/Fax

Practice location:
  • Phone: 803-327-1181
  • Fax: 803-327-9650
Mailing address:
  • Phone: 803-328-1181
  • Fax: 803-327-9650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number451
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: