Provider Demographics
NPI:1396111217
Name:HONEYCUTT, RICHARD
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HONEYCUTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726C N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:PAGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29728-1518
Mailing Address - Country:US
Mailing Address - Phone:843-517-1365
Mailing Address - Fax:
Practice Address - Street 1:726C N MAPLE ST
Practice Address - Street 2:
Practice Address - City:PAGELAND
Practice Address - State:SC
Practice Address - Zip Code:29728-1518
Practice Address - Country:US
Practice Address - Phone:843-517-1365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver