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General NPI Number Information
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NPI Number | 1447282736
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Entity Type | Organization
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Legal Business Name | UNIVERSITY SPECIALTY CLINICS - OPHTHALMOLOGY
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | FOUR MEDICAL PARK SUITE 100
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City | COLUMBIA
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State | SC
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Zip | 29203-6863
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Country | US
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Telephone | 803-434-6836
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Fax | 803-434-1581
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Provider Business Mailing Address
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Address Line | 15 MEDICAL PARK SUITE 300
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City | COLUMBIA
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State | SC
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Zip | 29203-6843
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Country | US
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Telephone | 803-545-5022
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Fax | 803-256-0977
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Authorized Official
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Title or Position | CHAIR
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Name | WILLIAM D ANDERSON
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Credential | MD
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Telephone | 803-434-6836
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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 |
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License Number State |
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