Healthcare Provider Details

I. General information

NPI: 1891374443
Provider Name (Legal Business Name): JOSEPH ALEXANDER CHAFARDON II DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 HOLMESTOWN RD
MYRTLE BEACH SC
29588-7837
US

IV. Provider business mailing address

PO BOX 421718
GEORGETOWN SC
29442-4203
US

V. Phone/Fax

Practice location:
  • Phone: 843-652-8440
  • Fax: 843-652-8441
Mailing address:
  • Phone: 843-527-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number83632
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: