| |
309 E 1st Ave Easley SC 29640-3040 | |
(864) 859-6331 | |
(864) 855-1045 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 309 E 1st Ave, Easley, South Carolina |
Authorized Official Name and Position | Kathleen M Stapleton (CFO) |
Authorized Official Contact | 8644428610 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2089 Easley SC 29641-2089 Ph: (864) 855-5104 | 309 E 1st Ave Easley SC 29640-3040 Ph: (864) 859-6331 |
NPI Number | 1528299732 |
---|---|
Provider Enumeration Date | 08/05/2009 |
Last Update Date | 09/24/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528299732 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (South Carolina) | Primary |
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 | |