Provider Demographics
NPI:1710662440
Name:DAVIS, KARYSSA HUYNH (OD)
Entity Type:Individual
Prefix:
First Name:KARYSSA
Middle Name:HUYNH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CIRCLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-4742
Mailing Address - Country:US
Mailing Address - Phone:843-640-1383
Mailing Address - Fax:
Practice Address - Street 1:3050 ASHLEY TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5664
Practice Address - Country:US
Practice Address - Phone:843-460-2013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2410152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist