# BROAD RIVER PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hilton Head Primary Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962795989
- **Authorized official:** MR. WESLEY O. JAMES (REGIONAL CFO, TENET)
- **Authorized official phone:** (404) 265-5009

## Contact information

- **Practice address:** 35 BILL FRIES DR, ISLAND MEDICAL PLAZA BUILDING A, HILTON HEAD ISLAND, SC 29926-2730
- **Practice address phone:** (843) 682-7470
- **Practice address fax:** (843) 682-2042
- **Mailing address:** PO BOX 741720, ATLANTA, GA 30374-1720
- **Mailing address phone:** (843) 682-7470
- **Mailing address fax:** (843) 682-2042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/24/2011
- **Last updated:** 05/26/2016