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NPI Code Detail

MEDICARE: DR. BENJAMIN JULY BITTNER O.D.

MEDICARE:  DR. BENJAMIN JULY BITTNER  O.D.
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
1152W00000XOptometrist1455SC

Other Identifiers

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

General Provider Information

NPI Number : 1518185180
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN JULY BITTNER O.D.
Provider Business Mailing Address
First Line : 341 PALMETTO GLEN DR
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-6396
Country : US
Telephone Number : 843-748-0038
Fax Number :
Provider Business Practice Location Address
First Line : 9403 HIGHWAY 707 STE C
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-7758
Country : US
Telephone Number : 843-443-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2007
Last Update Date : 06/26/2019

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Directions to “ DR. BENJAMIN JULY BITTNER O.D.” Practice Location

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