| Mcleod Family Medicine - Latta | |
|
108a East Main Street Latta SC 29565-1617 | |
| (843) 752-5111 | |
| (843) 752-5100 |
| Full Name | Mcleod Family Medicine - Latta |
|---|---|
| Speciality | Family Medicine |
| Location | 108a East Main Street, Latta, South Carolina |
| Authorized Official Name and Position | Paul Provenzano (REGIONAL PRACTICE MANAGER/AVP) |
| Authorized Official Contact | 8437777030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcleod Family Medicine - Latta Po Box 3239 Florence SC 29502-3239 Ph: (843) 752-5111 | Mcleod Family Medicine - Latta 108a East Main Street Latta SC 29565-1617 Ph: (843) 752-5111 |
| NPI Number | 1689869018 |
|---|---|
| Provider Enumeration Date | 09/10/2007 |
| Last Update Date | 03/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689869018 | NPI | - | NPPES |
| GP4874 | Medicaid | SC |
Marion Medical Group-latta Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108a E Main St, Latta, SC 29565 Phone: 843-752-1234 Fax: 843-752-1108 | |
Caresouth Carolina Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 122 Latimer St, Latta, SC 29565 Phone: 843-857-0111 |