Provider Demographics
NPI:1639141930
Name:SPEARMAN, WILLIAM W (OD, PA)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:SPEARMAN
Suffix:
Gender:M
Credentials:OD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-2385
Mailing Address - Country:US
Mailing Address - Phone:864-878-6060
Mailing Address - Fax:864-878-6275
Practice Address - Street 1:306 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2385
Practice Address - Country:US
Practice Address - Phone:864-878-6060
Practice Address - Fax:864-878-6275
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDD7320Medicaid
SCDA1000Medicaid
SC8191Medicare PIN
SCT24772Medicare UPIN
SC5362260001Medicare NSC