Healthcare Provider Details

I. General information

NPI: 1922934892
Provider Name (Legal Business Name): HILTON HEAD REGIONAL PHYSICIAN GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HOSPITAL CENTER BLVD
HILTON HEAD ISLAND SC
29926-2734
US

IV. Provider business mailing address

PO BOX 604411
CHARLOTTE NC
28260-4411
US

V. Phone/Fax

Practice location:
  • Phone: 980-217-2025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: LEEA JEANINE WALTON
Title or Position: RCS MANAGER
Credential:
Phone: 704-316-6081