Corcoran, David G

Corcoran, David G is an individual health care provider with primary practice located at 210 Mills Ave , Greenville SC 29605-4020. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Corcoran, David G can be contacted via phone (864) 232-2779.

Contact Information

Primary practice address
210 Mills Ave Greenville SC 29605-4020
Phone: (864) 232-2779
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X 948 South Carolina
Eye and Vision Services Providers / Optometrist 152W00000X 948 South Carolina

Profile Details

NPI number 1649259805
LBN Legal business name Corcoran, David G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 15th, 2006
Last updated Nov 22nd, 2017 - about 7 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 1649259805 NPPES
South Carolina Other 51-0604811 TAX ID NO.
South Carolina MEDICAID DO9480 TAX ID NO.

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