| Carolina Family Practice P A | |
|
208 Swift Creek Rd Hartsville SC 29550-4383 | |
| (843) 383-0770 | |
| (843) 383-5856 |
| Full Name | Carolina Family Practice P A |
|---|---|
| Speciality | Family Medicine |
| Location | 208 Swift Creek Rd, Hartsville, South Carolina |
| Authorized Official Name and Position | Kenneth C Evans (MD/OWNER) |
| Authorized Official Contact | 8433830770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Family Practice P A 208 Swift Creek Rd Hartsville SC 29550-4383 Ph: (843) 383-0770 | Carolina Family Practice P A 208 Swift Creek Rd Hartsville SC 29550-4383 Ph: (843) 383-0770 |
| NPI Number | 1760479620 |
|---|---|
| Provider Enumeration Date | 10/05/2005 |
| Last Update Date | 03/06/2015 |
| Medicare PECOS PAC ID | 1052593480 |
|---|---|
| Medicare Enrollment ID | O20110307000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760479620 | NPI | - | NPPES |
| GP2918 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 10933 (South Carolina) | Primary |
| Provider Name | Shari K Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457383317 PECOS PAC ID: 6507926748 Enrollment ID: I20081118000758 |
| Provider Name | Joseph Williamson Powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255525820 PECOS PAC ID: 9032264668 Enrollment ID: I20090903000628 |
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