CAROLINA FACIAL PLASTIC SURGERY PA (NPI# 1679594261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679594261 |
| Entity Type | Organization |
| Organization Name | CAROLINA FACIAL PLASTIC SURGERY PA |
| Practice Address |
1714 Gregg Ave Florence SC 29501-4120 |
| Practice Telephone | 8436650400 |
| Practice Fax Number | 8436678487 |
| Mailing Telephone | 8436650400 |
| Mailing Fax Number | 8436678487 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-01-21 |
| Authorized Official Name | DR. CARLA CAMILLE GRAHAM (PRACTICE OWNER) |
| Authorized Official Telephone | 8436650400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
16126 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP2827 | 05 |
| Street Address |
1714 GREGG AVE |
| City | FLORENCE |
| State | SC |
| Zip Code | 29501-4120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871541789 | Carla Camille Graham | Specialist | 1714 Gregg Ave, Florence, SC 29501-4120 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700350444 | Angel Edwards Brown | Nurse Practitioner | Mcleod Health, 555 East Cheves Street, Florence, SC 29501 | 2019-01-16 |
| 1497229124 | Fred L. Evans IIi | Physical Therapy Assistant | 2439 Willwood Dr., Florence, SC 29501 | 2019-01-16 |
| 1841715596 | Faith Hope Love Homecare | Home Health | 604 S. Coit Street, Florence, SC 29501 | 2017-08-03 |
| 1083156350 | Karen Artis-bacote | Nurse Practitioner | 3835 Susan Dr, Florence, SC 29501 | 2016-11-17 |
| 1992251581 | Higher Ground Christian Counseling Service, LLC | Counselor | 1801 D West Evans Street, Florence, SC 29501 | 2016-09-01 |
| 1952752818 | Jack Carter Shackelford | Chiropractor | 311 West Palmetto Street, Florence, SC 29501 | 2016-06-22 |
| 1750743506 | Profection Therapy LLC | Clinic/Center | 315d North Beltline Dr., Florence, SC 29501 | 2016-03-22 |
| 1386002467 | Bergelt Optometric LLC | Optometrist | 2672 David Mcleod Blvd, Florence, SC 29501 | 2016-02-04 |
| 1437531993 | Sherika Tarshall Stuckey | Nurse Practitioner | 720 Coventry Lane, Apt C, Florence, SC 29501 | 2015-06-22 |
| 1245610062 | Christopher Tyree | Podiatrist | 709 W Evans St, Florence, SC 29501 | 2015-06-06 |
| Find all providers in zip 29501 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386989028 | Coastal Carolina Ent, Do, Pa | Otolaryngology | 110 Highway 17 S, Suite 112 - Sundial Center, North Myrtle Beach, SC 29582-3118 | 2012-12-06 |
| 1316917057 | Peter C Bondy | Otolaryngology | 808 Farrar Dr, Conway, SC 29526-8747 | 2006-01-25 |
| 1194144493 | Charleston Facial Plastic Surgery LLC | Otolaryngology | 67 Broad St, Suite 200, Charleston, SC 29401-2936 | 2014-04-15 |
| 1043471394 | Stephen J. Kroll, M.d. Pa | Otolaryngology | 338 Harbison Blvd, Columbia, SC 29212-2248 | 2008-06-19 |
| 1063687325 | David Watson Rodwell IIi | Otolaryngology | 67 Broad St, Suite 200, Charleston, SC 29401-2936 | 2008-04-28 |
| 1487857272 | Patrick Constantine Angelos | Otolaryngology | 2295 Henry Tecklenburg Dr, Charleston, SC 29414-7801 | 2007-06-07 |
| 1629299375 | Drew V Collins | Otolaryngology | 105 Carter Park Dr, Suite B, Seneca, SC 29678-1152 | 2007-05-01 |
| 1518181148 | Daniel Frederick Boxwell | Otolaryngology | 105 Carter Park Dr, Suite B, Seneca, SC 29678-1152 | 2007-04-13 |
| 1386698165 | Seacoast Ent & Facial Plastic Surgery, Pa | Otolaryngology | 4000 Highway 9 E, Suite 270, Little River, SC 29566-7833 | 2006-05-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.