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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164491718 NPPES
South Carolina MEDICAID D06795

Popular Providers