Provider Demographics
NPI:1477512101
Name:CLOWNEY, BILLY WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:WAYNE
Last Name:CLOWNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1244
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-1244
Mailing Address - Country:US
Mailing Address - Phone:803-934-8833
Mailing Address - Fax:803-934-0776
Practice Address - Street 1:1105 N LAFAYETTE DR
Practice Address - Street 2:SUITE A
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2913
Practice Address - Country:US
Practice Address - Phone:803-934-8833
Practice Address - Fax:803-934-0776
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14777207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC147772Medicaid
SCF57439Medicare UPIN
SCF574396958Medicare ID - Type Unspecified