Provider Demographics
NPI:1649496803
Name:ACAYLAR, JOSEPH VILLANEUVA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:VILLANEUVA
Last Name:ACAYLAR
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 1:360 N IRBY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-2808
Mailing Address - Country:US
Mailing Address - Phone:843-667-9414
Mailing Address - Fax:843-667-1362
Practice Address - Street 1:210 E MARKET ST
Practice Address - Street 2:
Practice Address - City:TIMMONSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29161-1812
Practice Address - Country:US
Practice Address - Phone:843-346-3730
Practice Address - Fax:843-346-7687
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC303335Medicaid
SCAA2313Medicare UPIN
SC303335Medicaid