| NPI | 1295458610 |
|---|---|
| Doing Business As | MCLEOD PRIMARY CARE LAKE CITY |
| Entity Type | Organization |
| Authorized Contact | KENNETH BEASLEY Senior Vice President 843-777-7010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-09-21 |