Park, Dorothy J
Park, Dorothy J is an sole proprietor health care provider with primary practice located at 1818 Hampton St , Columbia SC 29201-3534. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Park, Dorothy J can be contacted via phone (803) 254-6306.Contact Information
Primary practice address
1818 Hampton St
Columbia SC 29201-3534
Phone: (803) 254-6306
Fax: (803) 771-6745
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 858 | South Carolina |
Profile Details
| NPI number | 1932183852 |
|---|---|
| LBN Legal business name | Park, Dorothy J |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2005 |
| Last updated | Nov 28th, 2011 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932183852 | NPPES |
| South Carolina | MEDICAID | D08588 | |
| South Carolina | Other | 57-1062179 |
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