Full Name | |
---|---|
Speciality | Family Medicine |
Location | 201 W A Ave, Easley, South Carolina |
Authorized Official Name and Position | Kendall Durham (PATIENT FINANACIAL MANAGER) |
Authorized Official Contact | 8648555104 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
201 W A Ave Easley SC 29640-2051 Ph: (864) 855-5104 | 201 W A Ave Easley SC 29640-2051 Ph: (864) 855-5104 |
NPI Number | 1235174848 |
---|---|
Provider Enumeration Date | 06/18/2006 |
Last Update Date | 11/18/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235174848 | NPI | - | NPPES |
GP4456 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | 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 | |