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NPI Code Detail

MEDICARE: KEITH S. ROCKWILEY PA

MEDICARE: KEITH S. ROCKWILEY PA
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
1363AM0700XMedical Physician AssistantC0002414MD

General Provider Information

NPI Number : 1750471967
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH S. ROCKWILEY PA
Provider Business Mailing Address
First Line : 2849 DOGWOOD RD
Second Line :
City : TIMMONSVILLE
State : SC
Zip : 29161-8614
Country : US
Telephone Number : 843-346-1035
Fax Number :
Provider Business Practice Location Address
First Line : 301 E JACKSON ST
Second Line : EMERGENCY DEPT.
City : DILLON
State : SC
Zip : 29536-2509
Country : US
Telephone Number : 843-774-4111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2006
Last Update Date : 01/15/2015

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Directions to “ KEITH S. ROCKWILEY PA” Practice Location

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