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General NPI Number Information
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NPI Number | 1134566417
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Entity Type | Organization
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Legal Business Name | ACUITY EYE CARE ASSOCIATES LLC
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 1009 BELLS HWY
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City | WALTERBORO
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State | SC
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Zip | 29488-2507
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Country | US
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Telephone | 843-549-2565
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Fax |
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Provider Business Mailing Address
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Address Line | 3178 CONSERVANCY LN
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City | CHARLESTON
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State | SC
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Zip | 29414-8111
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK AXFORD
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Credential | O.D.
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Telephone | 843-532-4906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1622
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License Number State | SC
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