MEDICARE: MCLEOD PHYSICIAN ASSOCIATES II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician		SC

General Provider Information

NPI Number	:	1326594995
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCLEOD PHYSICIAN ASSOCIATES II

Provider Business Mailing Address
First Line	:	PO BOX 3239
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29502-3239
Country	:	US
Telephone Number	:	843-777-7042
Fax Number	:	843-777-7102

Provider Business Practice Location Address
First Line	:	101 MCLEOD HEALTH BLVD STE 201
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-4477
Country	:	US
Telephone Number	:	843-646-8001
Fax Number	:	843-646-8002

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	KENNETH D. BEASLEY
Credential	:
Telephone Number	:	843-777-7010

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	11/30/2022

Similar Medicare Providers

1831196773 — DR. JOHN Y. KARL MD
Practice Location Address:

101 MCLEOD HEALTH BLVD STE 201
MYRTLE BEACH, SC
29579-4477

Practice Phone: 843-646-8001
Practice Fax: 843-646-8002

1164419941 — DR. WILLIAM R. GAMMON MD
Practice Location Address:

101 MCLEOD HEALTH BLVD STE 201
MYRTLE BEACH, SC
29579-4477

Practice Phone: 843-646-8001
Practice Fax: 843-646-8002

1124331863 — DUSTIN L ECK MD
Practice Location Address:

115 MCLEOD HEALTH BLVD , BUILDING 3, SUITE 201
MYRTLE BEACH, SC
29579-4477

Practice Phone: 843-646-8430
Practice Fax: 843-646-8763

1457804080 — MCLEOD PHYSICIAN ASSOCIATES II
Practice Location Address:

107 MCLEOD HEALTH BLVD STE 202
MYRTLE BEACH, SC
29579-4477

Practice Phone: 843-839-1201
Practice Fax: 843-839-1202

1487197364 — LABORATORY CORPORATION OF AMERICA HOLDINGS
Practice Location Address:

107 MCLEOD HEALTH BLVD STE 202
MYRTLE BEACH, SC
29579-4477

Practice Phone: 843-798-4194
Practice Fax:

1184165714 — EMILY WHITEHURST FNP
Practice Location Address:

107 MCLEOD HEALTH BLVD STE 202
MYRTLE BEACH, SC
29579-4477

Practice Phone: 843-839-1201
Practice Fax: 843-839-1202

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