Provider Demographics
NPI:1568483568
Name:ANDERSON EYE & EAR ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:ANDERSON EYE & EAR ASSOCIATES, P.A.
Other - Org Name:MEDICUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-224-6375
Mailing Address - Street 1:PO BOX 4239
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-4239
Mailing Address - Country:US
Mailing Address - Phone:864-224-6375
Mailing Address - Fax:864-716-7738
Practice Address - Street 1:1655 E GREENVILLE ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-2062
Practice Address - Country:US
Practice Address - Phone:864-224-6375
Practice Address - Fax:864-716-7738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0610160001Medicare NSC
SC1262Medicare PIN