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811 W Main St Ste 204 Lexington SC 29072-2500 | |
(803) 358-6420 | |
(803) 358-6450 |
Full Name | |
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Speciality | Family Medicine |
Location | 811 W Main St Ste 204, 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: () - | 811 W Main St Ste 204 Lexington SC 29072-2500 Ph: (803) 358-6420 |
NPI Number | 1821696030 |
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Provider Enumeration Date | 10/12/2020 |
Last Update Date | 06/10/2024 |
Identifier | Type | State | Issuer |
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1821696030 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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