Mcleod Physician Associates II
NPI #1689869018 in Latta, South Carolina
Provider Information
- NPI Number
- 1689869018
- Entity Type
- Organization
- Organization Name
- Mcleod Physician Associates II
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MCLEOD HEALTH
- Primary Specialty
- Family Medicine
- Enumeration Date
- Sep 10, 2007
- Last Updated
- Mar 27, 2009
Practice Location
- Address
- 108A EAST MAIN STREET
- City
- Latta
- State
- South Carolina
- ZIP Code
- 29565-1617
- Phone
- (843) 752-5111
Authorized Official
- Name
- MR. PAUL PROVENZANO
- Title
- REGIONAL PRACTICE MANAGER/AVP
- Phone
- (843) 777-7030
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
| Nurse Practitioner - Family — Family |
| Family Medicine |
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