Georgetown Physician Services, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GEORGETOWN PHYSICIAN SERVICES, LLC

Practice address

1075 N Fraser St
Georgetown, SC 29440-2848

Phone

(843) 527-4442

Fax

(843) 527-4027

NPI assigned

Sep 13, 2010

Organization subpart

No

Name

Ms. Sue Stark

Title

Coadministrator

Phone

(843) 543-0090

Tax ID family

Waccamaw Family Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Georgetown Physician Services LLC

  • Internal Medicine Physician
  • Georgetown, SC
  • NPI 1912186206
  NPD tax ID
• Georgetown Physician Services, LLC

  • Family Medicine Physician
  • Pawleys Island, SC
  • NPI 1962691402
  NPD tax ID

• Waccamaw Family Medicine Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 13, 2010.

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1497062384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9699 OCEAN HWY",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857425",
            "telephone_number": "843-237-4297",
            "fax_number": "843-237-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402848",
            "telephone_number": "843-527-4442",
            "fax_number": "843-527-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN PHYSICIAN SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-13",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "COADMINISTRATOR",
        "authorized_official_telephone_number": "843-543-0090",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waccamaw Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Georgetown Physician Associates, LLC
• Georgetown Physician Associates, LLC
• Georgetown Physician Associates, LLC
• Georgetown Physician Associates, LLC
• Georgetown Physician Services LLC
• Georgetown Radiation Therapy Center
• Georgetown Radiology
• Georgetown Treatment Specialists LLC
• Dana Patete Giarrizzi, D.O.
• Stephanie C Gibson, LPC

• All providers in Georgetown, SC
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.