Organization
SOUTHERN COAST SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CODY L PALMER (CEO)
(843) 870-8127
Entity
Organization
Contact information
Practice address
1055 RIBAUT RD STE 30, BEAUFORT, SC 29902-5447
(843) 870-8127
Mailing address
9565 HIGHWAY 78 BLDG 100, LADSON, SC 29456-4118
(843) 870-8127
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
2083X0100X
Occupational Medicine Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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