Healthcare Provider Details

I. General information

NPI: 1437182474
Provider Name (Legal Business Name): ANESTHESIOLOGY CONSULTANTS OF FLORENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 PAMPLICO HWY
FLORENCE SC
29505
US

IV. Provider business mailing address

PO BOX 14015
FLORENCE SC
29505
US

V. Phone/Fax

Practice location:
  • Phone: 843-674-2890
  • Fax: 843-674-2906
Mailing address:
  • Phone: 843-674-1405
  • Fax: 843-674-2906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: DR. THOMAS WALTER PHILLIPS JR.
Title or Position: MANAGER
Credential: MD
Phone: 843-674-1405