Provider Demographics
NPI:1508921495
Name:JEFFREY R GEER OD PC
Entity Type:Organization
Organization Name:JEFFREY R GEER OD PC
Other - Org Name:FAMILY EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:GEER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-593-4508
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:SC
Mailing Address - Zip Code:29822-0280
Mailing Address - Country:US
Mailing Address - Phone:803-593-4508
Mailing Address - Fax:803-593-4504
Practice Address - Street 1:4592 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:BEECH ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29842-4872
Practice Address - Country:US
Practice Address - Phone:803-593-4508
Practice Address - Fax:803-593-4504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC974152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDA9892Medicaid
SCDA9892Medicaid
SCU34592Medicare UPIN