Provider Demographics
NPI:1841344710
Name:COASTAL EYE GROUP, PC
Entity type:Organization
Organization Name:COASTAL EYE GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:K
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:843-449-7115
Mailing Address - Street 1:90 CEDAR LIGHT LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-6978
Mailing Address - Country:US
Mailing Address - Phone:843-280-8779
Mailing Address - Fax:843-280-6669
Practice Address - Street 1:90 CEDAR LIGHT LN
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-6978
Practice Address - Country:US
Practice Address - Phone:843-280-8779
Practice Address - Fax:843-280-6669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013F4Medicaid
SCGP3046Medicaid
SC6831Medicare PIN