=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508870726
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM E OQUINN M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2006
-----------------------------------------------------
Last Update Date | 10/08/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 215 DORANGE RD
-----------------------------------------------------
City | BRANCHVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29432-2241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-274-8400
-----------------------------------------------------
Fax | 803-274-8817
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1245
-----------------------------------------------------
City | ORANGEBURG
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29116-1245
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-395-4499
-----------------------------------------------------
Fax | 803-395-4480
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 007265
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------