Healthcare Provider Details

I. General information

NPI: 1861653768
Provider Name (Legal Business Name): KATIE GRUBBS PRICE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WHEELER AVE
PROSPERITY SC
29127-9332
US

IV. Provider business mailing address

PO BOX 630
PROSPERITY SC
29127-0630
US

V. Phone/Fax

Practice location:
  • Phone: 334-255-7000
  • Fax:
Mailing address:
  • Phone: 803-364-4852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16019
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: