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Contact Information

RUFUS B. ANTLEY, OD
149 N. MAIN ST
WAGENER, SC29164
 Phone: 803-564-6728
 Fax: 803-564-6750
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for RUFUS B. ANTLEY, OD

NPI Number 1124103536
LBN Legal business name RUFUS B. ANTLEY, OD
Authorized official BARBARA ANTLEY - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/25/2006
Last updated 04/20/2008 - About 18 years ago
Identifiers
SC License # 433
SC Medicaid DA9844
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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