Individual
KENNETH M FAILE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 S. GEORGETOWN HWY, JOHNSONVILLE, SC 29555
(843) 380-2000
(843) 380-2014
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 380-2000
(843) 380-2014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19643
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T35012
—
SC
Enumeration date
02/09/2006
Last updated
02/02/2021
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