Healthcare Provider Details

I. General information

NPI: 1215900675
Provider Name (Legal Business Name): JAMES S GARNER IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3032 E HIGHWAY 76
MULLINS SC
29574-7396
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-292-7332
  • Fax: 843-292-7324
Mailing address:
  • Phone: 843-292-7332
  • Fax: 843-292-7324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8470
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: