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General NPI Number Information
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NPI Number | 1356622013
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Entity Type | Individual
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Provider Name | DUC TRAN OD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 100 PALMETTO HEALTH PKWY STE 350
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City | COLUMBIA
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State | SC
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Zip | 29212-1756
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Country | US
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Telephone | 803-907-2020
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Fax | 803-907-7720
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Provider Business Mailing Address
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Address Line | PO BOX 743904
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City | ATLANTA
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State | GA
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Zip | 30374-3904
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Country | US
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Telephone | 803-296-7320
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Fax | 803-296-7330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 8684TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | AT-4430
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2272
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License Number State | SC
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