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General NPI Number Information
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NPI Number | 1205175502
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Entity Type | Organization
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Legal Business Name | YORK PRIMARY AND PREVENTIVE MEDICINE PC
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 115 STONE VILLAGE DR
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City | FORT MILL
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State | SC
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Zip | 29708-6489
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Country | US
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Telephone | 803-548-7300
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Fax | 803-548-7301
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Provider Business Mailing Address
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Address Line | 115 STONE VILLAGE DR
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City | FORT MILL
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State | SC
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Zip | 29708-6489
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Country | US
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Telephone | 803-548-7300
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Fax | 803-548-7301
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOHN MURPHY
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Credential | M.D.
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Telephone | 803-548-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 16761
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License Number State | SC
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