Healthcare Provider Details

I. General information

NPI: 1235197286
Provider Name (Legal Business Name): JOHN L SAUNDERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 HIGHWAY 378
LEXINGTON SC
29072-8316
US

IV. Provider business mailing address

1818 HENDERSON ST
COLUMBIA SC
29201-2647
US

V. Phone/Fax

Practice location:
  • Phone: 803-359-5533
  • Fax: 803-359-0127
Mailing address:
  • Phone: 803-758-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12467
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: