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Organization

COLLETON OTOLARYNGOLOGY, HEAD & NECK SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK PICKETT (VICE-PRESIDENT OF OPERATIONS)
(678) 762-5037
Entity
Organization

Contact information

Practice address
302 MEDICAL PARK DR, SUITE 211, WALTERBORO, SC 29488-5747
(843) 813-6397
(866) 302-2249
Mailing address
302 MEDICAL PARK DR, SUITE 211, WALTERBORO, SC 29488-5747
(843) 813-6397
(866) 302-2249

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
08/23/2006
Last updated
02/04/2008
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