Provider Demographics
NPI:1871032086
Name:PPCP SPECIALTY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:PPCP SPECIALTY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:BRANTLEY
Authorized Official - Last Name:ARNAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-572-7727
Mailing Address - Street 1:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-695-6071
Mailing Address - Fax:
Practice Address - Street 1:9313 MEDICAL PLAZA DR
Practice Address - Street 2:STE 310
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9155
Practice Address - Country:US
Practice Address - Phone:843-569-1856
Practice Address - Fax:843-569-1879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC202482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty