DISTINCTIVE EYEWEAR VISION CENTER NPI 1174806053

NPI Information

  • NPI: 1174806053
  • Provider Name: DISTINCTIVE EYEWEAR VISION CENTER
  • Classification: Optometrist - 152W00000X
  • Entity Type: Organization
  • Address: 1206 MOSER DR
    THE MARKET COMMON
    MYRTLE BEACH, SC
    ZIP 29577
  • Phone: (843) 213-1201

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NPI Details

DISTINCTIVE EYEWEAR VISION CENTER is an optometrist in Myrtle Beach, SC. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. DISTINCTIVE EYEWEAR VISION CENTER NPI is 1174806053. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1206 MOSER DR
THE MARKET COMMON
MYRTLE BEACH, SC
ZIP 29577-575
Phone: (843) 213-1201

The provider's authorized official is Lauri Baldwin Graham .
The authorized official title is Owner and has the following contact phone number (843) 213-1201.

The enumeration date for this NPI number is 9/27/2011 and was last updated on 9/27/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometrist1396SOUTH CAROLINAYes

What is NPI?

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This page was last updated on: 11/21/2025

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