National Provider Identifier Database

JACKSON DAVENPORT INC
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

JACKSON DAVENPORT INC.
379 KING ST
CHARLESTON, SC29401-1438
Phone: 843-722-4416
Fax: 843-720-8984
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X
Contact Lens Fitter 156FC0801X
Corneal and Contact Management 152WC0802X
Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for JACKSON DAVENPORT INC.

NPI Number 1073688602
Legal business name
LBN
JACKSON DAVENPORT INC.
Authorized official NANCY DAVENPORT - (MANAGER)
Entity Organization
Organization subpart No
Enumeration date 11/21/2006
Last updated 07/16/2014 - About 12 years ago
Sole proprietor1 Not specified
Identifiers
  • SC License #: 152
  • SC License #: 501
  • SC License #: 509
  • SC Medicaid: DA9859
  • SC Other: 62167 FIRST CHOICE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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