Organization
LAKE CITY FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORRIS EDWARD BROWN III MD (OWNER)
(843) 374-8380
Entity
Organization
Contact information
Practice address
901 N. MATTHEWS RD., LAKE CITY, SC 29560
(843) 374-8380
Mailing address
901 N. MATTHEWS RD., LAKE CITY, SC 29560
(843) 374-8380
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
SC
261QR1300X
Rural Health Clinic/Center
17100
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4692
—
SC
01
—
RHC175
RURAL HEALTH CLINIC
SC
Enumeration date
04/12/2007
Last updated
03/16/2009
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