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106 John Street Easley SC 29640-1415 | |
(864) 859-2220 | |
(864) 859-5744 |
Full Name | |
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Speciality | Family Medicine |
Location | 106 John Street, Easley, South Carolina |
Authorized Official Name and Position | Kendall Durham (PATIENT FINANCIAL MANAGER) |
Authorized Official Contact | 8648555104 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2089 Easley SC 29641-2089 Ph: (864) 855-5104 | 106 John Street Easley SC 29640-1415 Ph: (864) 859-2220 |
NPI Number | 1043260029 |
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Provider Enumeration Date | 05/11/2006 |
Last Update Date | 08/13/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043260029 | NPI | - | NPPES |
GP2406 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Fleetwood Internal Medicine Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 109b Fleetwood Dr, Easley, SC 29640 Phone: 864-855-1036 Fax: 864-855-3318 | |