MEDICARE: COASTAL EYE GROUP, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician		SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477663706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL EYE GROUP, P.C.

Provider Business Mailing Address
First Line	:	150 VILLAGE CENTER BLVD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-6618
Country	:	US
Telephone Number	:	843-449-7115
Fax Number	:	843-497-2960

Provider Business Practice Location Address
First Line	:	150 VILLAGE CENTER BLVD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-6618
Country	:	US
Telephone Number	:	843-449-7115
Fax Number	:	843-497-2960

Authorized Official
Title or Position	:	OWNER
Name	:	FRANK KEENAN SLOAN
Credential	:	M.D.
Telephone Number	:	843-449-7115

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/19/2025

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