Provider Demographics
NPI:1841272010
Name:MILFORD, WILLIAM J (OPTOMETRIST)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:MILFORD
Suffix:
Gender:M
Credentials:OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 896189
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28289-0838
Mailing Address - Country:US
Mailing Address - Phone:864-654-6706
Mailing Address - Fax:
Practice Address - Street 1:1220 N FANT ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4822
Practice Address - Country:US
Practice Address - Phone:864-654-6706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1006152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD10067Medicaid
SCU466594347Medicare PIN
SCU466591541Medicare PIN
SCU466594345Medicare PIN
SCU46659Medicare UPIN
SC0622020001Medicare NSC