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General NPI Number Information
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NPI Number | 1982668646
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Entity Type | Individual
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Provider Name | JOHN FUNKE III MD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 25 HOSPITAL CENTER BLVD STE 101
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City | HILTON HEAD
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State | SC
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Zip | 29926-2735
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Country | US
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Telephone | 843-689-6490
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Fax |
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Provider Business Mailing Address
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Address Line | 8526 OYSTER FACTORY RD
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City | EDISTO ISLAND
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State | SC
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Zip | 29438-6876
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Country | US
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Telephone | 864-337-2899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 11930
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License Number State | SC
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