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General NPI Number Information
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NPI Number | 1689781304
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Entity Type | Organization
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Legal Business Name | PEE DEE EYE ASSOCIATES
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 603 E MAIN ST
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City | BENNETTSVILLE
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State | SC
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Zip | 29512-3217
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Country | US
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Telephone | 843-332-7171
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Fax | 843-332-7802
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Provider Business Mailing Address
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Address Line | 603 E MAIN ST
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City | BENNETTSVILLE
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State | SC
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Zip | 29512-3217
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Country | US
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Telephone | 843-332-7171
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Fax | 843-332-7802
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LAURA ELIZABETH NEWMAN
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Credential |
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Telephone | 843-332-7171
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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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