# LOW COUNTRY ANESTHESIA, PA

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

## Provider details

- **NPI number:** 1417928268
- **Authorized official:** GARY A THOMPSON (PRESIDENT)
- **Authorized official phone:** (843) 522-5087

## Contact information

- **Practice address:** 955 RIBAUT ROAD, BEAUFORT, SC 29902
- **Practice address phone:** (843) 522-5087
- **Practice address fax:** (843) 522-5007
- **Mailing address:** PO BOX 74, COLUMBIA, SC 29202
- **Mailing address phone:** (803) 765-1838
- **Mailing address fax:** (803) 765-1732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 01/30/2006
- **Last updated:** 10/04/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP0001 | — | SC |