Provider Demographics
NPI:1679014138
Name:SOUTHEASTERN VISION INSTITUTE LLC
Entity Type:Organization
Organization Name:SOUTHEASTERN VISION INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WARING
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:843-216-2020
Mailing Address - Street 1:735 JOHNNIE DODDS BLVD
Mailing Address - Street 2:101
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3058
Mailing Address - Country:US
Mailing Address - Phone:843-216-2020
Mailing Address - Fax:
Practice Address - Street 1:735 JOHNNIE DODDS BLVD
Practice Address - Street 2:101
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3058
Practice Address - Country:US
Practice Address - Phone:843-216-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD32317207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty