Dean, Mark Tracy
Dean, Mark Tracy is an sole proprietor health care provider with primary practice located at 4886 Socastee Blvd , Myrtle Beach SC 29588-7245. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dean, Mark Tracy can be contacted via phone (843) 293-1555.Contact Information
Primary practice address
4886 Socastee Blvd
Myrtle Beach SC 29588-7245
Phone: (843) 293-1555
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 679 | South Carolina |
Profile Details
| NPI number | 1164491718 |
|---|---|
| LBN Legal business name | Dean, Mark Tracy |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 16th, 2006 |
| Last updated | Aug 16th, 2011 - about 13 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 | 1164491718 | NPPES |
| South Carolina | MEDICAID | D06795 |
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