James-Willmot Clinic

Organization Active NPI General Practice Physician · Woodruff, SC

NPI 1730144262 · NPPES record last updated May 2, 2013

Key facts

NPI
1730144262
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
JAMES-WILLMOT CLINIC
Practice address
100 Medical Center Dr
Woodruff, SC 29388-8704
Phone
(864) 476-8191
Fax
(864) 476-8193
NPI assigned
Apr 18, 2006
Organization subpart
No

Authorized official

Name
C Janice Campbell
Title
Practice Manager
Phone
(864) 476-8191

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

100 Medical Center Dr
Woodruff, SC 29388-8704

Mailing address

100 Medical Center Dr
Woodruff, SC 29388-8704
Phone (864) 476-8191

Other identifiers

IdentifierTypeStateIssuer
CM2784OtherSCMEDICARE ID TYPE UNSPECIFIED
GP0597MedicaidSC

Other providers in Woodruff, SC

All providers in Woodruff, SC · General Practice Physician in South Carolina

Sources for this page

Verify at the official NPI Registry.