Provider Demographics
NPI:1619538477
Name:HUNEYCUTT, RICHARD DARYL (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DARYL
Last Name:HUNEYCUTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:803-522-8604
Mailing Address - Fax:
Practice Address - Street 1:115 N SUMTER ST STE 400
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4971
Practice Address - Country:US
Practice Address - Phone:803-934-0810
Practice Address - Fax:803-934-0809
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC82285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine