Healthcare Provider Details

I. General information

NPI: 1437130861
Provider Name (Legal Business Name): KERSHAW FAMILY MEDICINE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 E MARION ST
KERSHAW SC
29067-1442
US

IV. Provider business mailing address

216 E MARION ST
KERSHAW SC
29067-1442
US

V. Phone/Fax

Practice location:
  • Phone: 803-475-3475
  • Fax: 803-475-5360
Mailing address:
  • Phone: 803-475-3475
  • Fax: 803-475-5360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES M TIMMONS JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 803-475-3475