Organization
SOUTH CAROLINA INPATIENT MEDICINE ASSOCIATES, LLC
Active
Parent organization
EAGLE HOSPITAL PHYSICIANS
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAGLE HOSPITAL PHYSICIANS
Authorized official
DR. TALBOT GREEN MCCORMICK III MD (PRESIDENT-CHIEF OPERATING OFFICER)
(678) 441-8500
Entity
Organization
Contact information
Practice address
200 FLEETWOOD DR, EASLEY, SC 29640-2022
(678) 441-8500
(675) 441-8656
Mailing address
PO BOX 96368, OKLAHOMA CITY, OK 73143-6368
(678) 441-8500
(678) 441-8646
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447202536
BCBS
SC
01
—
DD0096
RR MEDICARE
SC
05
—
GP4053
—
SC
Enumeration date
05/17/2006
Last updated
07/12/2013
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