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NPI Code Detail

MEDICARE: DR. DONALD ELMER BARTLETT JR. M.D.

MEDICARE: DR. DONALD ELMER BARTLETT JR. M.D.
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
1207QA0401XAddiction Medicine (Family Medicine) Physician0101039372VA
2207QA0401XAddiction Medicine (Family Medicine) Physician91744SC

General Provider Information

NPI Number : 1912062142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD ELMER BARTLETT JR. M.D.
Provider Business Mailing Address
First Line : 506 E CHEVES ST STE 202
Second Line :
City : FLORENCE
State : SC
Zip : 29506-2616
Country : US
Telephone Number : 843-366-2900
Fax Number : 843-366-2450
Provider Business Practice Location Address
First Line : 2021 N MYRTLE POINT BLVD STE 101
Second Line :
City : NORTH MYRTLE BEACH
State : SC
Zip : 29582-2224
Country : US
Telephone Number : 843-366-2900
Fax Number : 843-366-2450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2006
Last Update Date : 09/11/2024

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