Healthcare Provider Details

I. General information

NPI: 1568414555
Provider Name (Legal Business Name): COMPREHENSIVE NEUROLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 W PALMETTO STREET
FLORENCE SC
29501
US

IV. Provider business mailing address

PO BOX 7124
FLORENCE SC
29502-7124
US

V. Phone/Fax

Practice location:
  • Phone: 843-669-2007
  • Fax: 843-669-6677
Mailing address:
  • Phone: 843-669-2007
  • Fax: 843-669-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number18276
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number22902
License Number StateSC

VIII. Authorized Official

Name: WALTER JAMES EVANS
Title or Position: DOCTOR
Credential: MD
Phone: 843-669-2007