MEDICARE: DR. FRANCIS WESTON SHEALY III 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
1	152W00000X	Optometrist	1365	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA44710381	OTHER	SC	MEDICARE PTAN

General Provider Information

NPI Number	:	1891780508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS WESTON SHEALY III O.D.

Provider Business Mailing Address
First Line	:	3010 COOPERS BASIN CIR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-8030
Country	:	US
Telephone Number	:	813-431-6889
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 SAVANNAH HWY
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7826
Country	:	US
Telephone Number	:	843-763-2270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	11/06/2018

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