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Organization

MCLEOD PHYSICIAN ASSOCIATES II

Active
Parent organization
MCLEOD HEALTH
Other names
McLeod Pediatric Subspecialties
Organization subpart
Yes

Provider details

NPI number
Legal business name
MCLEOD HEALTH
Authorized official
KENNETH D. BEASLEY (SENIOR VICE PRESIDENT)
(843) 777-7010
Entity
Organization

Contact information

Practice address
101 WILLIAM H. JOHNSON STREET, STE. 400, FLORENCE, SC 29506-2772
(843) 777-7300
(843) 777-7311
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-7300
(843) 777-7311

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
2080P0203X
Pediatric Critical Care Medicine Physician
2080P0205X
Pediatric Endocrinology Physician
2080P0206X
Pediatric Gastroenterology Physician
363LF0000X
Family Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
=========
BLUE CHOICE
SC
05
GP3648
SC
Enumeration date
02/14/2006
Last updated
06/03/2022
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