Provider Demographics
NPI:1336317593
Name:FLOYD, JAMES L JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:FLOYD
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1624 MAIN STREET AGAPE SENIOR PRIMARY CARE, INC.,
Mailing Address - Street 2:DBA AGAPE PHYSICIANS CARE
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201
Mailing Address - Country:US
Mailing Address - Phone:803-454-0365
Mailing Address - Fax:803-404-6000
Practice Address - Street 1:128A PROFESSIONAL PARK PLACE
Practice Address - Street 2:AGAPE PHYSICIANS CARE
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9260
Practice Address - Country:US
Practice Address - Phone:843-914-1057
Practice Address - Fax:843-914-1058
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2014-09-02
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Provider Licenses
StateLicense IDTaxonomies
SC10343207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4505Medicaid
SC7844Medicare PIN