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NPI Code Detail

MEDICARE: LATOYA FORD

MEDICARE: LATOYA FORD
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
1172A00000XDriver007494117SC

General Provider Information

NPI Number : 1679279418
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATOYA FORD
Provider Business Mailing Address
First Line : 136 FORUM DR STE 4
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-7980
Country : US
Telephone Number : 803-237-1672
Fax Number :
Provider Business Practice Location Address
First Line : 136 FORUM DR STE 4
Second Line :
City : COLUMBIA
State : SC
Zip : 29229-7980
Country : US
Telephone Number : 803-237-1672
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2023
Last Update Date : 02/02/2023

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Directions to “ LATOYA FORD ” Practice Location

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