Live Oak Medical Center, PA
NPI #1144455197 in Lake City, South Carolina
Provider Information
- NPI Number
- 1144455197
- Entity Type
- Organization
- Organization Name
- Live Oak Medical Center, PA
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- LIVE OAK MEDICAL CENTER, PA
- Primary Specialty
- Family Medicine
- Enumeration Date
- May 20, 2009
- Last Updated
- May 17, 2010
Practice Location
- Address
- 148 SAULS ST.
- City
- Lake City
- State
- South Carolina
- ZIP Code
- 29560
- Phone
- (843) 687-0435
Authorized Official
- Name
- ALBERT DURANT MIMS, M.D.
- Title
- DIRECTOR
- Phone
- (843) 687-0435
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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