Organization
MCLEOD PHYSICIAN ASSOCIATES II
Active
Parent organization
MCLEOD HEALTH
Other names
McLeod Urology Associates
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
800 E CHEVES ST, SUITE 350, FLORENCE, SC 29506-2650
(843) 665-2000
(843) 669-1701
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 665-2000
(843) 669-1701
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
21941
SC
208800000X
Urology Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034
BCBS
SC
01
—
035
TRICARE
SC
01
—
065
BLUECHOICE
SC
01
—
56162
MEDCOST
SC
05
—
5950404
—
NC
05
—
GP4960
—
SC
Enumeration date
09/08/2008
Last updated
06/07/2022
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