Healthcare Provider Details

I. General information

NPI: 1487619383
Provider Name (Legal Business Name): PATRICK ALLEN HONAKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E PALMETTO ST
FLORENCE SC
29506-2851
US

IV. Provider business mailing address

412 KIMBALL DR
MARION SC
29571-1916
US

V. Phone/Fax

Practice location:
  • Phone: 843-667-9414
  • Fax: 843-667-1362
Mailing address:
  • Phone: 843-423-9057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number17870
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number9500942
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number17870
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: