| |
122 Powell Dr Lexington SC 29072-9203 | |
(803) 957-8400 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 122 Powell Dr, Lexington, South Carolina |
Authorized Official Name and Position | Jeffrey Brillhart (SENIOR VP/CFO) |
Authorized Official Contact | 8037912967 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 6069 West Columbia SC 29171-6069 Ph: () - | 122 Powell Dr Lexington SC 29072-9203 Ph: (803) 957-8400 |
NPI Number | 1376140764 |
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Provider Enumeration Date | 10/08/2020 |
Last Update Date | 10/24/2023 |
Identifier | Type | State | Issuer |
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1376140764 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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