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LIBERTY DOCTORS LLC NPI 1881639862


NPI Information

NPI: 1881639862
Provider Name: LIBERTY DOCTORS, LLC

Doing Business As: FAMILY FIRST MEDICAL CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1483 TOBIAS GADSON BLVD
SUITE 206
CHARLESTON, SC
ZIP 29407
Phone: (843) 766-1936
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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 1881639862. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Family First Medical Care.

The provider's business location address is:

1483 TOBIAS GADSON BLVD
SUITE 206
CHARLESTON, SC
ZIP 29407-702
Phone: (843) 766-1936
Fax: (843) 766-1206

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 enumeration date for this NPI number is 6/16/2006 and was last updated on 10/21/2016.


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 MedicineSC0310SOUTH CAROLINANo
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
2D27209MEDICARE UPINSOUTH CAROLINA
3A634MEDICARE UPINSOUTH CAROLINA
4GP3558MEDICAIDSOUTH CAROLINA
57261MEDICARE PINSOUTH 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: 11/14/2023

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