Provider Demographics
NPI:1689229270
Name:PALMETTO PHYSICIANS SERVICES, LLC
Entity Type:Organization
Organization Name:PALMETTO PHYSICIANS SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAGROVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-335-4666
Mailing Address - Street 1:PO BOX 49547
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-0010
Mailing Address - Country:US
Mailing Address - Phone:615-335-4666
Mailing Address - Fax:864-330-1864
Practice Address - Street 1:1822 MONTEREY RD
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-4659
Practice Address - Country:US
Practice Address - Phone:615-335-4666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty