| Southern Eye Associates Of South Carolina, Pa | |
|
113 Doctors Dr, Greenville, SC 29605-5608 | |
| (864) 269-3333 | |
| (864) 295-1288 |
| Full Name | Southern Eye Associates Of South Carolina, Pa |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 113 Doctors Dr, Greenville, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215933510 | NPI | - | NPPES |
| 1396841599 | Other | SC | NPI |
| 335998 | Medicaid | SC | |
| 52668 | Medicaid | SC | |
| 1053369777 | Other | SC | NPI |
| DA9608 | Medicaid | SC | |
| 153549 | Medicaid | SC | |
| 1548218340 | Other | SC | NPI |
| 6180 | Other | SC | MEDICARE GROUP NUMBER GREER OFFICE |
| 1760431035 | Other | SC | NPI |
| D17998 | Medicaid | SC | |
| TL5190 | Medicaid | SC | |
| 130735 | Medicaid | SC | |
| 1437107836 | Other | SC | NPI |
| 1639127046 | Other | SC | NPI |
| PA6449 | Medicaid | SC | |
| T48026 | Medicaid | SC | |
| 1205122975 | Other | MO | NPI |
| 1571 | Other | SC | MEDICARE GROUP GREENVILLE OFFICE NUMBER |
| 1821439878 | Other | SC | NPI |
| 1295886125 | Other | SC | NPI |
| GP2766 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Bradley B Williams |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1437107836 PECOS PAC ID: 8527025790 Enrollment ID: I20050215000204 |
| Provider Name | Kurt F Heitman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1548218340 PECOS PAC ID: 1355399023 Enrollment ID: I20050215000235 |
| Provider Name | Douglas W Stokes |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639127046 PECOS PAC ID: 3971560145 Enrollment ID: I20050215000248 |
| Provider Name | William R Steigerwald |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396841599 PECOS PAC ID: 0547268781 Enrollment ID: I20110715000441 |
| Provider Name | Peter Goodwin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649488594 PECOS PAC ID: 1951471275 Enrollment ID: I20111013000461 |
| Provider Name | Craig Allen Odell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821439878 PECOS PAC ID: 5597989921 Enrollment ID: I20140605000089 |
| Provider Name | Wade Alex Reardon |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1205122975 PECOS PAC ID: 4183939531 Enrollment ID: I20150814013291 |
| Provider Name | Jeffrey Van Swearingen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972656692 PECOS PAC ID: 6103018643 Enrollment ID: I20161220000542 |
| Provider Name | Stanley Tyler Pace |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1366717605 PECOS PAC ID: 4284927054 Enrollment ID: I20180712002538 |
| Provider Name | Andrew Ernest Hack |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1770927212 PECOS PAC ID: 9335429554 Enrollment ID: I20180716002786 |
| Provider Name | Peter Benjamin Daniel |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1831500206 PECOS PAC ID: 9537447768 Enrollment ID: I20190703000440 |
| Provider Name | Scott Andrew Mogavero |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033780754 PECOS PAC ID: 4284012923 Enrollment ID: I20220608000905 |
| Provider Name | Charles Andrew Pickens |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760120885 PECOS PAC ID: 5698154599 Enrollment ID: I20220623001977 |
| Provider Name | Justin W Lee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285670513 PECOS PAC ID: 0749414639 Enrollment ID: I20220908002874 |
| Provider Name | Melissa Anne Ixcamey |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1245761055 PECOS PAC ID: 5698044246 Enrollment ID: I20230601003180 |
| Provider Name | Caleb Thomas Senn |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083241772 PECOS PAC ID: 3870903305 Enrollment ID: I20240726001249 |
| Provider Name | David Bradford Williams |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1649632027 PECOS PAC ID: 9739626797 Enrollment ID: I20240808000171 |
| Provider Name | Robert C Foster |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1104323401 PECOS PAC ID: 6406199629 Enrollment ID: I20240822001697 |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Eye Associates Of South Carolina, Pa 113 Doctors Dr, Greenville, SC 29605-5608 Ph: (864) 269-3333 | Southern Eye Associates Of South Carolina, Pa 113 Doctors Dr, Greenville, SC 29605-5608 Ph: (864) 269-3333 |