# SEA ISLAND MEDICAL PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sea Island Medical Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285702498
- **Authorized official:** KAITLYN ATKINSON AEMT (OFFICE MANAGER)
- **Authorized official phone:** (909) 964-4917

## Contact information

- **Practice address:** 12 PROFESSIONAL VILLAGE CIR, LADYS ISLAND, SC 29907-1569
- **Practice address phone:** (843) 524-6829
- **Practice address fax:** (843) 524-6820
- **Mailing address:** 12 PROFESSIONAL VILLAGE CIR, LADYS ISLAND, SC 29907-1569
- **Mailing address phone:** (843) 524-6829
- **Mailing address fax:** (843) 524-5820

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/04/2006
- **Last updated:** 05/12/2026