# MCLEOD PHYSICIAN ASSOCIATES II

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MCLEOD HEALTH
- **Other names:** McLeod Urology Associates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649428194
- **Legal business name:** MCLEOD HEALTH
- **Authorized official:** KENNETH D. BEASLEY (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (843) 777-7010

## Contact information

- **Practice address:** 800 E CHEVES ST, SUITE 350, FLORENCE, SC 29506-2650
- **Practice address phone:** (843) 665-2000
- **Practice address fax:** (843) 669-1701
- **Mailing address:** PO BOX 3239, FLORENCE, SC 29502-3239
- **Mailing address phone:** (843) 665-2000
- **Mailing address fax:** (843) 669-1701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 21941 | SC | — |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/08/2008
- **Last updated:** 06/07/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 034 | BCBS | SC |
| 01 | — | 035 | TRICARE | SC |
| 01 | — | 065 | BLUECHOICE | SC |
| 01 | — | 56162 | MEDCOST | SC |
| 05 | — | 5950404 | — | NC |
| 05 | — | GP4960 | — | SC |