# SUNGATE MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114322336
- **Authorized official:** DR. KENNETH DANIEL FARR MD (SOLE MEMBER)
- **Authorized official phone:** (843) 842-2020

## Contact information

- **Practice address:** 10 WILLIAM POPE DR, BLUFFTON, SC 29909-7549
- **Practice address phone:** (843) 842-2020
- **Practice address fax:** (843) 705-1512
- **Mailing address:** 10 WILLIAM POPE DR, BLUFFTON, SC 29909-7549
- **Mailing address phone:** (843) 842-2020
- **Mailing address fax:** (843) 705-1512

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/30/2014
- **Last updated:** 02/04/2020