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Organization

EXCELSIOR MEDICAL CLINIC, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH CECIL WILLIAMS MD (PRESIDENT)
(803) 778-2429
Entity
Organization

Contact information

Practice address
448 N MAIN ST, EXCELSIOR MEDICAL CLINIC, PA, SUMTER, SC 29150-4233
(803) 778-2429
(803) 773-6303
Mailing address
448 N MAIN ST, EXCELSIOR MEDICAL CLINIC, PA, SUMTER, SC 29150-4233
(803) 778-2429
(803) 773-6303

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9647
SC
208D00000X
General Practice Physician
9646
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA5850
SC
Enumeration date
05/19/2006
Last updated
10/09/2007
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