Provider Demographics
NPI:1235861352
Name:PYLES, STEPHEN DOUGLAS (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DOUGLAS
Last Name:PYLES
Suffix:
Gender:M
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:605 SAINT JAMES AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-2766
Mailing Address - Country:US
Mailing Address - Phone:843-553-0244
Mailing Address - Fax:843-553-7335
Practice Address - Street 1:605 SAINT JAMES AVE STE 1
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-2766
Practice Address - Country:US
Practice Address - Phone:843-553-0244
Practice Address - Fax:843-553-7335
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician