Healthcare Provider Details

I. General information

NPI: 1912091265
Provider Name (Legal Business Name): DAPHNE LANETTE ATKINS M.D., D.V.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1547 PARKWAY
GREENWOOD SC
29646-4081
US

IV. Provider business mailing address

284 TRANQUIL RD
GREENWOOD SC
29646-9242
US

V. Phone/Fax

Practice location:
  • Phone: 864-229-7120
  • Fax: 864-229-5526
Mailing address:
  • Phone: 864-229-6405
  • Fax: 864-229-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number15569
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: