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Organization

LAKE CITY FAMILY MEDICINE

Active
Parent organization
LAKE CITY FAMILY MEDICINE
Other names
Family Medicine Asociates
Organization subpart
Yes

Provider details

NPI number
Legal business name
LAKE CITY FAMILY MEDICINE
Authorized official
MORRIS E BROWN (MEDICAL DIRECTOR)
(843) 374-8380
Entity
Organization

Contact information

Practice address
505 THURGOOD MARSHALL HWY, KINGSTREE, SC 29556-4107
(843) 355-8380
Mailing address
505 THURGOOD MARSHALL HWY, KINGSTREE, SC 29556-4107

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1831445998
SC
Enumeration date
10/03/2017
Last updated
10/03/2017
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