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LIBERTY DOCTORS LLC NPI 1689051369


NPI Information

NPI: 1689051369
Provider Name: LIBERTY DOCTORS, LLC

Doing Business As: HUGH D. DURRENCE, MD, PC (SITE NPI)

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 42D0950827

Address:
418 FOLLY RD STE A
CHARLESTON, SC
ZIP 29412
Phone: (843) 795-5362
Get Directions

LIBERTY DOCTORS, LLC is a family medicine in Charleston, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LIBERTY DOCTORS, LLC NPI is 1689051369. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Hugh D. Durrence, Md, Pc (site Npi).

The provider's business location address is:

418 FOLLY RD STE A
CHARLESTON, SC
ZIP 29412-625
Phone: (843) 795-5362
Fax: (843) 795-1921

The provider's authorized official is Sara Elizabeth Maynor-hardy .
The authorized official title is Credentialing Coordinator and has the following contact phone number (843) 225-8320.

The CLIA number assigned to this NPI record is 42D0950827 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2015 and was last updated on 9/9/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207Q00000XFamily MedicineSOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP6738MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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