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General NPI Number Information
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NPI Number | 1750595690
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Entity Type | Organization
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Legal Business Name | DRS KELLEY & MCDOWELL PA
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 112 EAST HILTON ST
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City | KERSHAW
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State | SC
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Zip | 29067
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Country | US
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Telephone | 803-475-6075
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Fax | 803-475-6077
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Provider Business Mailing Address
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Address Line | PO BOX 98
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City | KERSHAW
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State | SC
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Zip | 29067
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Country | US
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Telephone | 803-475-6075
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Fax | 803-475-6077
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JAMES JEFFERSON MCDOWELL JR.
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Credential | OD
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Telephone | 803-475-6075
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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 | 613
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License Number State | SC
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