| Summerton Family Medicine Llc | |
|
107 Main Street Summerton SC 29148 | |
| (803) 485-2351 | |
| (803) 485-2219 |
| Full Name | Summerton Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 107 Main Street, Summerton, South Carolina |
| Authorized Official Name and Position | David T. Koon (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8034852351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summerton Family Medicine Llc Po Box 10 Summerton SC 29148-0010 Ph: (803) 485-2351 | Summerton Family Medicine Llc 107 Main Street Summerton SC 29148 Ph: (803) 485-2351 |
| NPI Number | 1093707416 |
|---|---|
| Provider Enumeration Date | 08/22/2005 |
| Last Update Date | 05/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093707416 | NPI | - | NPPES |
| F891927161 | Other | SC | MEDICARE PROVIDER |
| GP3257 | Medicaid | SC | |
| CJ8906 | Other | SC | MEDICARE ID RETIRED RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Dr. J Daulton Dubose Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1056 Felton Street, Summerton, SC 29148 Phone: 803-111-1111 | |
Dr. J. Daulton Dubose Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1056 Felton St, Summerton, SC 29148 Phone: 803-488-9355 Fax: 803-488-9358 | |
K & M Care Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1056 Felton St, Summerton, SC 29148 Phone: 843-819-4021 |