Jackson Davenport Inc. - Optometrist in Charleston, SC

Jackson Davenport Inc. is a Optometrist based in Charleston, South Carolina. Jackson Davenport Inc. is licensed to practice in South Carolina (license number 509) and their current practice location is 379 King St, Charleston, South Carolina. It can be reached at their office (for appointments etc.) via phone at (843) 722-4416.

NPI number for Jackson Davenport Inc. is 1073688602 and their current mailing address is Po Box 20236, Charleston, South Carolina. Jackson Davenport Inc. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1073688602.

Contact Information

Jackson Davenport Inc.
379 King St,
Charleston, SC 29401-1438
(843) 722-4416
(843) 720-8984



Healthcare Provider's Profile

Full NameJackson Davenport Inc.
TypeFacility
SpecialityOptometrist
Location379 King St, Charleston, South Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1073688602
  • Provider Enumeration Date: 11/21/2006
  • Last Update Date: 07/16/2014

Medical Identifiers

Medical identifiers for Jackson Davenport Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073688602NPI-NPPES
62167OtherSCFIRST CHOICE
DA9859MedicaidSC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 509 (South Carolina)Primary
152WC0802XOptometrist - Corneal And Contact Management 509 (South Carolina)Secondary
156FC0801XTechnician/technologist - Contact Lens Fitter 152 (South Carolina)Secondary
156FX1800XTechnician/technologist - Optician 501 (South Carolina)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jackson Davenport Inc. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jackson Davenport Inc.
Po Box 20236,
Charleston, SC 29413-0236

Ph: (843) 722-4416
Jackson Davenport Inc.
379 King St,
Charleston, SC 29401-1438

Ph: (843) 722-4416

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Optometrist in Charleston, SC

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