Provider Demographics
NPI:1457568040
Name:CAROLINA CORNEA AND LASER CENTER
Entity type:Organization
Organization Name:CAROLINA CORNEA AND LASER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:V
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-286-3700
Mailing Address - Street 1:200 PATEWOOD DR
Mailing Address - Street 2:SUITE B180
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-6316
Mailing Address - Country:US
Mailing Address - Phone:864-286-3700
Mailing Address - Fax:864-286-6003
Practice Address - Street 1:121 HALTON VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6825
Practice Address - Country:US
Practice Address - Phone:864-286-3700
Practice Address - Fax:864-286-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14400207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC144007Medicaid
SC1254590001Medicare NSC
SCE12491Medicare UPIN