Organization
SUNGATE PRIMARY CARE
Active
Parent organization
PALMETTO EYE SPECIALISTS PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PALMETTO EYE SPECIALISTS PA
Authorized official
DR. KENNETH DANIEL FARR MD (MEDICAL DIRECTOR)
(843) 842-2020
Entity
Organization
Contact information
Practice address
10 WILLIAM POPE DRIVE, SUNGATE MEDICAL CENTER, BLUFFTON, SC 29909
(843) 705-1510
(843) 705-1511
Mailing address
10 WILLIAM POPE DRIVE, SUNGATE MEDICAL CENTER, BLUFFTON, SC 29909
(843) 705-1510
(843) 705-1511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO 985
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH3121
RAILROAD MEDICARE
—
05
—
GP2666
—
SC
Enumeration date
11/15/2012
Last updated
11/15/2012
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