Individual
JOSEPH K BETHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
920 DOUG WHITE DR STE 130, MYRTLE BEACH, SC 29572-4180
(843) 848-1440
(843) 839-1654
Mailing address
920 DOUG WHITE DR STE 130, MYRTLE BEACH, SC 29572-4180
(843) 848-1440
(843) 839-1654
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
630
SC
363AS0400X
Surgical Physician Assistant
A630
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
QM0497
—
SC
Enumeration date
04/22/2006
Last updated
02/01/2022
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