# GARY J BARRETT MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Corporation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982642880
- **Authorized official:** DR. GARY J BARRETT MD (OWNER)
- **Authorized official phone:** (843) 756-8090

## Contact information

- **Practice address:** 3109 CASEY ST, LORIS, SC 29569
- **Practice address phone:** (843) 756-8090
- **Mailing address:** PO BOX 156, LORIS, SC 29569
- **Mailing address phone:** (843) 756-8090
- **Mailing address fax:** (843) 756-6122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 11051 | SC | Yes |

## Other

- **Enumeration date:** 06/03/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 890136N | — | NC |
| 05 | — | GP0648 | — | SC |