# HARDEEVILLE MEDICAL GROUP, LLC

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

## Provider details

- **NPI number:** 1871870170
- **Authorized official:** MR. WESLEY O. JAMES (REGIONAL CFO, TENET)
- **Authorized official phone:** (404) 265-5009

## Contact information

- **Practice address:** 1010 MEDICAL CENTER DR, SUITE 240, HARDEEVILLE, SC 29927-3447
- **Practice address phone:** (843) 784-8297
- **Practice address fax:** (843) 784-7998
- **Mailing address:** PO BOX 741905, ATLANTA, GA 30374-1905
- **Mailing address phone:** (843) 784-8297
- **Mailing address fax:** (843) 784-7998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 11/15/2011
- **Last updated:** 06/08/2016