| Dr Justine Siegers Petty, OD | |
|
121 Lucy Ln, Columbia, SC 29229-7835 | |
| (803) 217-2550 | |
| (803) 217-2548 |
| Full Name | Dr Justine Siegers Petty |
|---|---|
| Gender | Female |
| Speciality | Optometrist |
| Location | 121 Lucy Ln, Columbia, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740592237 | NPI | - | NPPES |
| SC1603 | Other | SC | OPTOMETRIST LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152WC0802X | Optometrist - Corneal And Contact Management | SC1603 (South Carolina) | Secondary |
| 152W00000X | Optometrist | 1603 (South Carolina) | Primary |
| Provider Name | Aeg South Carolina Professional Pc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1720768427 PECOS PAC ID: 5597129064 Enrollment ID: O20230918000311 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Justine Siegers Petty, OD Po Box 1107, Irmo, SC 29063 Ph: (803) 781-2123 | Dr Justine Siegers Petty, OD 121 Lucy Ln, Columbia, SC 29229-7835 Ph: (803) 217-2550 |
Bettina L Gary, OD Optometrist Medicare: Medicare Enrolled Practice Location: 7539 Garners Ferry Rd, Columbia, SC 29209 Phone: 803-779-9313 Fax: 803-779-9551 | |
Insyte Llc Optometrist Medicare: Medicare Enrolled Practice Location: 1513 Gregg St, Columbia, SC 29201 Phone: 803-257-4951 | |
Look, Pc Optometrist Medicare: Medicare Enrolled Practice Location: 332 Long Pointe Ln, Columbia, SC 29229 Phone: 803-419-8907 | |
Dr. Alexis Noelle Broussard, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 280 Harbison Blvd Ste T, Columbia, SC 29212 Phone: 803-732-9200 | |
Dr. Mohamed Shabir Bharadia, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1326 Bush River Rd, At Walmart Vision Center, Columbia, SC 29210 Phone: 803-750-4949 Fax: 803-750-7172 | |
Dr. Krystal Leigh Berthelette, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 5420 Forest Dr, Columbia, SC 29206 Phone: 803-790-4600 | |
Drs Eyecare, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 620 Gervais St, Suite B, Columbia, SC 29201 Phone: 803-779-1001 Fax: 803-779-1089 |