Organization
LOW COUNTRY ANESTHESIA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY A THOMPSON (PRESIDENT)
(843) 522-5087
Entity
Organization
Contact information
Practice address
955 RIBAUT ROAD, BEAUFORT, SC 29902
(843) 522-5087
(843) 522-5007
Mailing address
PO BOX 74, COLUMBIA, SC 29202
(803) 765-1838
(803) 765-1732
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0001
—
SC
Enumeration date
01/30/2006
Last updated
10/04/2007
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