Provider Demographics
NPI:1427004985
Name:WINSTON C FLOYD MD PA
Entity Type:Organization
Organization Name:WINSTON C FLOYD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:CORDELL
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-224-2197
Mailing Address - Street 1:400 NORTH FANT STREET
Mailing Address - Street 2:SUITE G
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5720
Mailing Address - Country:US
Mailing Address - Phone:864-224-2197
Mailing Address - Fax:864-225-0033
Practice Address - Street 1:400 NORTH FANT STREET
Practice Address - Street 2:SUITE G
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5720
Practice Address - Country:US
Practice Address - Phone:864-224-2197
Practice Address - Fax:864-225-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC073057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA3512Medicaid
SCD47045Medicare UPIN
SCPA3512Medicaid