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SELF MEDICAL GROUP NPI 1730432873


NPI Information

NPI: 1730432873
Provider Name: SELF MEDICAL GROUP

Other Name: FAMILY HEALTHCARE CLINTON

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 42D1087330

Address:
22580 HIGHWAY 76 E
SUITE 100
LAURENS, SC
ZIP 29360
Phone: (864) 833-5986
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SELF MEDICAL GROUP is a family medicine in Laurens, 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. SELF MEDICAL GROUP NPI is 1730432873. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Family Healthcare Clinton.

The provider's business location address is:

22580 HIGHWAY 76 E
SUITE 100
LAURENS, SC
ZIP 29360-439
Phone: (864) 833-5986
Fax: (864) 833-0599

The provider's authorized official is Matthew T Logan .
The authorized official title is President And Ceo and has the following contact phone number (864) 725-4253.

The CLIA number assigned to this NPI record is 42D1087330 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/25/2012 and was last updated on 12/14/2021.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineSOUTH CAROLINAYes

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: 5/5/2024

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