Healthcare Provider Details

I. General information

NPI: 1184729808
Provider Name (Legal Business Name): MCLEOD PHYSICIAN ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E. CHEVES ST STE 460
FLORENCE SC
29506
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-7000
  • Fax: 843-777-7005
Mailing address:
  • Phone: 843-777-7000
  • Fax: 843-777-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JEANNE L MOREHOUSE
Title or Position: DIR OF OPERATIONS
Credential:
Phone: 843-777-7000