Summerton Family Medicine Llc

LBN: Summerton Family Medicine Llc
Summerton Family Medicine Llc is an health care organization with primary practice located at 107 Main Street , Summerton SC 29148. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Summerton Family Medicine Llc can be contacted via phone (803) 485-2351, or through Koon, David T. via phone (803) 485-2351.

Contact Information

Primary practice address
107 Main Street Summerton SC 29148
Phone: (803) 485-2351
Fax: (803) 485-2219
Website:
Map and Directions
Authorized official contact:
Name: Koon, David T. Doctor of Medicine (MD)
Phone: (803) 485-2351

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1093707416
LBN Legal business name Summerton Family Medicine Llc
DBA Doing business as
Authorized official Koon, David T. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 22nd, 2005
Last updated May 8th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093707416 NPPES
South Carolina Other F891927161 MEDICARE PROVIDER
South Carolina MEDICAID GP3257 MEDICARE PROVIDER
South Carolina Other CJ8906 MEDICARE PROVIDER

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