Organization
COASTAL CAROLINA ENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI KINKEAD (OFFICE ADMINISTRATOR)
(843) 663-9090
Entity
Organization
Contact information
Practice address
3806 SAWTELL RD, LITTLE RIVER, SC 29566-7873
(843) 663-9090
(843) 663-9091
Mailing address
3806 SAWTELL RD, LITTLE RIVER, SC 29566-7873
(846) 663-9090
(843) 663-9091
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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