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General NPI Number Information
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NPI Number | 1942252721
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Entity Type | Individual
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Provider Name | WILLIAM H MOORE OD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 615 LAURENS ST
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City | CAMDEN
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State | SC
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Zip | 29020-3523
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Country | US
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Telephone | 803-432-9874
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Fax | 803-432-8441
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Provider Business Mailing Address
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Address Line | P.O. BOX 1259
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City | CAMDEN
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State | SC
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Zip | 29021-1259
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Country | US
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Telephone | 803-713-8350
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Fax | 803-713-8433
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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 | 0596
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License Number State | SC
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