Provider Demographics
NPI:1497987218
Name:PHYSICIAN'S EYE CENTER, LLC
Entity Type:Organization
Organization Name:PHYSICIAN'S EYE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:GLEICHAUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-642-4339
Mailing Address - Street 1:1051 SILVER BLUFF RD STE A
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5855
Mailing Address - Country:US
Mailing Address - Phone:803-642-4339
Mailing Address - Fax:803-649-6799
Practice Address - Street 1:1051 SILVER BLUFF RD STE A
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5855
Practice Address - Country:US
Practice Address - Phone:803-642-4339
Practice Address - Fax:803-649-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty