MEDICARE: PHILLIP & COKER OB-GYN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DD5603	OTHER	SC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285693606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLIP & COKER OB-GYN LLC

Provider Business Mailing Address
First Line	:	PO BOX 60423
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0423
Country	:	US
Telephone Number	:	843-629-7074
Fax Number	:

Provider Business Practice Location Address
First Line	:	1590 FREEDOM BLVD
Second Line	:	STE. B
City	:	FLORENCE
State	:	SC
Zip	:	29505-6071
Country	:	US
Telephone Number	:	843-665-9581
Fax Number	:	843-669-6426

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MS. SHARON POSTON
Credential	:
Telephone Number	:	843-629-7074

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	04/20/2008

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