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General NPI Number Information
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NPI Number | 1396286878
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Entity Type | Organization
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Legal Business Name | J. WILLIAM THURMOND III, MD LLC
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 509 W MARTINTOWN RD
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841
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Country | US
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Telephone | 803-426-1994
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Fax | 706-855-6658
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Provider Business Mailing Address
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Address Line | 509 W MARTINTOWN RD
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-3108
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Country | US
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Telephone | 803-426-1994
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Fax | 706-855-6658
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN WILLIAM THURMOND
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Credential | MD
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Telephone | 803-279-4561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 8076
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License Number State | SC
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