Provider Demographics
NPI:1437277753
Name:RAMSBOTTOM, JOHN GARNETT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GARNETT
Last Name:RAMSBOTTOM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-3112
Mailing Address - Country:US
Mailing Address - Phone:843-249-2451
Mailing Address - Fax:843-249-4100
Practice Address - Street 1:86 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3112
Practice Address - Country:US
Practice Address - Phone:843-249-2451
Practice Address - Fax:843-249-4100
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9264207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00076369OtherRR MEDICARE
SC092642Medicaid
SCP00076369OtherRR MEDICARE
SC092642Medicaid