Organization
MCLEOD PHYSICIAN ASSOCIATES II
Active
Parent organization
MCLEOD HEALTH
Other names
McLeod Family Medicine - Johnsonville
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCLEOD HEALTH
Authorized official
SAMUEL FULTON ERVIN III (SR VICE PRESIDENT AND CFO)
(843) 777-2910
Entity
Organization
Contact information
Practice address
355 SOUTH GEORGETOWN HIGHWAY, 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
—
—
261QR1300X
Rural Health Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2568
—
SC
05
—
RHC176
—
SC
Enumeration date
09/12/2006
Last updated
08/08/2019
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