Individual
DR. THEODORE RICHARDSON MCRACKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
011634855
SC
207Y00000X
Otolaryngology Physician
Primary
37983
SC
Other
Enumeration date
04/09/2008
Last updated
11/13/2020
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