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Individual

DR. JAMES FLETCHER KOON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
206 S MATSON ST, KERSHAW, SC 29067-1506
(803) 475-1156
(803) 475-1128
Mailing address
206 S MATSON ST, KERSHAW, SC 29067-1506
(803) 475-1156
(803) 475-1128

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18339
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000229650
UNISON
SC
01
01153584
AMERIGROUP
SC
01
0141069
CAROLINA CARE
SC
01
080179118
RETIRED RR MEDICARE
SC
01
20071782
SELECT HEALTH
SC
01
21149333031
BEECHSTREET
SC
01
3091345
CIGNA
SC
01
5532095
AETNA
SC
01
8874326
PPNI
SC
01
A8973
MEDCOST
SC
05
T24079
SC
Enumeration date
12/23/2005
Last updated
08/05/2008
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