Healthcare Provider Details

I. General information

NPI: 1508425323
Provider Name (Legal Business Name): DILLON LEE BRIGGMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 06/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GENERAL PSYCHIATRY 15 MEDICAL PARK, STE 141
COLUMBIA SC
29203
US

IV. Provider business mailing address

GENERAL PSYCHIATRY 15 MEDICAL PARK, STE 141
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-1433
  • Fax: 803-434-4062
Mailing address:
  • Phone: 803-434-1433
  • Fax: 803-434-4062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberLL82738
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: