Provider Demographics
NPI:1104128917
Name:COASTAL EYE GROUP, P.C.
Entity type:Organization
Organization Name:COASTAL EYE GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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 1:401 79TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4310
Mailing Address - Country:US
Mailing Address - Phone:843-449-7115
Mailing Address - Fax:843-497-2960
Practice Address - Street 1:1200 HIGHMARKET ST STE 101
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-3227
Practice Address - Country:US
Practice Address - Phone:843-546-8421
Practice Address - Fax:843-546-1173
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COASTAL EYE GROUP, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-30
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6482260001Medicare NSC