| Mcleod Primary Care Carolina Forest 2 | |
|
107 Mcleod Health Blvd Ste 102 Myrtle Beach SC 29579-4477 | |
| (843) 777-7010 | |
| Not Available |
| Full Name | Mcleod Primary Care Carolina Forest 2 |
|---|---|
| Speciality | Family Medicine |
| Location | 107 Mcleod Health Blvd Ste 102, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Kenneth D. Beasley (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 8437777010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcleod Primary Care Carolina Forest 2 Po Box 3239 Florence SC 29502-3239 Ph: (843) 777-7120 | Mcleod Primary Care Carolina Forest 2 107 Mcleod Health Blvd Ste 102 Myrtle Beach SC 29579-4477 Ph: (843) 777-7010 |
| NPI Number | 1770241234 |
|---|---|
| Provider Enumeration Date | 12/02/2021 |
| Last Update Date | 11/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770241234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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