Organization
MARION REGIONAL HEALTHCARE SYSTEM
Active
Other names
Mullins Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
HAROLD E TUCKER (CEO)
(843) 431-2405
Entity
Organization
Contact information
Practice address
119 W LOWMAN ST, MULLINS, SC 29574-3107
(843) 464-4000
(843) 464-4017
Mailing address
119 W LOWMAN ST, MULLINS, SC 29574-3107
(843) 464-4000
(843) 464-4017
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079293
—
SC
05
—
GP4694
—
SC
Enumeration date
05/17/2007
Last updated
11/14/2007
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