Organization
SOUTHERN SURGICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR WARD POOLE (M.D)
(843) 399-9095
Entity
Organization
Contact information
Practice address
3600 SEA MOUNTAIN HWY SUITE A, LITTLE RIVER, SC 29566
(843) 399-9095
(843) 399-9098
Mailing address
3600 SEA MOUNTAIN HWY SUITE A, LITTLE RIVER, SC 29566
(843) 399-9095
(843) 399-9098
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
186449
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891743159
NPI
SC
Enumeration date
09/03/2013
Last updated
09/03/2013
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