Provider Demographics
NPI:1689649600
Name:VOSS, JOHN D (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:VOSS
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:6725 STATE PARK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-1831
Mailing Address - Country:US
Mailing Address - Phone:864-834-7311
Mailing Address - Fax:864-834-7019
Practice Address - Street 1:6725 STATE PARK RD
Practice Address - Street 2:SUITE B
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-1831
Practice Address - Country:US
Practice Address - Phone:864-834-7311
Practice Address - Fax:864-834-7019
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2015-03-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC867152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT251470281OtherMEDICARE PTAN
SCD08677Medicaid
SCD08677Medicaid
SCT25147Medicare UPIN