# GEORGETOWN PHYSICIAN ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tidelands Health Pain Management Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053704627
- **Authorized official:** ELIZABETH SUTHERLAND WARD (EVP & CFP)
- **Authorized official phone:** (843) 527-7102

## Contact information

- **Practice address:** 4040 HIGHWAY 17 UNIT 206, MURRELLS INLET, SC 29576-5098
- **Practice address phone:** (843) 652-8260
- **Practice address fax:** (843) 652-8269
- **Mailing address:** PO BOX 421718, GEORGETOWN, SC 29442-4203
- **Mailing address phone:** (843) 520-8883
- **Mailing address fax:** (843) 652-8422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | SC | Yes |

## Other

- **Enumeration date:** 03/06/2015
- **Last updated:** 06/25/2020