Organization
LOW COUNTRY UROLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES KEVIN O'KELLY M.D. (PHYSICIAN)
(843) 661-0402
Entity
Organization
Contact information
Practice address
1580 FREEDOM BLVD, SUITE 106, FLORENCE, SC 29505-6074
(843) 661-0402
(843) 661-0960
Mailing address
1580 FREEDOM BLVD, SUITE 106, FLORENCE, SC 29505-6074
(843) 661-0402
(843) 661-0960
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
163156
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
SC
01
—
163156
SC LICENSE NUMBER
SC
05
—
GP1485
—
SC
Enumeration date
06/04/2006
Last updated
08/22/2020
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