Croffead, Thomas George

Croffead, Thomas George is an individual health care provider with primary practice located at 3531 Mary Ader Ave Suite B, Charleston SC 29414-5896. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Croffead, Thomas George can be contacted via phone (843) 577-2047.

Contact Information

Primary practice address
3531 Mary Ader Ave Suite B Charleston SC 29414-5896
Phone: (843) 577-2047
Fax: (843) 577-0640
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 515 South Carolina

Profile Details

NPI number 1417934951
LBN Legal business name Croffead, Thomas George
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
Last updated Jul 21st, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417934951 NPPES
South Carolina MEDICAID D05153
South Carolina Other 406580115
South Carolina Other DA9789

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