Organization
ACS PRIMARY CARE PHYSICIANS - SOUTHEAST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDAL L. DABBS M.D. (PRESIDENT)
(865) 293-5210
Entity
Organization
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Mailing address
PO BOX 635003, CINCINNATI, OH 45263-0001
(800) 424-3672
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300041934A
—
GA
01
—
DC4477
MEDICARE TRAVELERS RR - G
GA
01
—
DO7575
RAILROAD MEDICARE
SC
Enumeration date
06/03/2006
Last updated
09/16/2019
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