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General NPI Number Information
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NPI Number | 1114280526
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Entity Type | Organization
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Legal Business Name | PALMETTO CATARACT AND EYE SPECIALISTS, LLC
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Dates
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Enumeration Date | 06/20/2012
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 515 CARNES CROSSING BLVD SUITE C
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City | SUMMERVILLE
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State | SC
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Zip | 29486
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Country | US
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Telephone | 843-259-2002
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Fax | 843-259-2005
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Provider Business Mailing Address
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Address Line | 515 CARNES CROSSING BLVD STE C
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City | SUMMERVILLE
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State | SC
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Zip | 29486-0412
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Country | US
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Telephone | 843-259-2002
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PRAT ITHARAT
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Credential | MD
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Telephone | 843-259-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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