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McLeod Physician Associates II

Organization Active NPI Family Medicine Physician · Dillon, SC

NPI 1568434249 · NPPES record last updated Mar 27, 2009

Key facts

NPI
1568434249
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
MCLEOD PHYSICIAN ASSOCIATES II
Practice address
207 E Monroe St
Dillon, SC 29536-2557
Phone
(843) 774-3736
Fax
(843) 774-4967
NPI assigned
Feb 6, 2006
Organization subpart
Yes
Parent organization (as reported)
MCLEOD HEALTH

Authorized official

Name
Paul Provenzano
Title
Regional Practice Manager/Avp
Phone
(843) 777-7030

Corporate family (same tax ID) 24

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

Practitioners 298

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 298

National Provider Directory

Tax ID family
McLeod Physician Associates II (138 organizations share this tax ID)

Locations

3980 Highway 9 E
Ste 100B
Little River, SC 29566
Phone (843) 390-5217

50 E Hospital St
Manning, SC 29102
Phone (803) 435-5224

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Rural Health Clinic/Center 261QR1300X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X

Addresses

Primary practice location

207 E Monroe St
Dillon, SC 29536-2557

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 774-3736

Other identifiers

IdentifierTypeStateIssuer
GP4322MedicaidSC

Other names

  • McLeod Family Medicine - Dillon Doing business as

Other providers in Dillon, SC

All providers in Dillon, SC · Family Medicine Physician in South Carolina

Sources for this page

Verify at the official NPI Registry.