Provider Demographics
NPI:1700827532
Name:EARLE, JULIUS R JR (MD)
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:R
Last Name:EARLE
Suffix:JR
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 1:2700 E PHILLIPS RD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-4815
Mailing Address - Country:US
Mailing Address - Phone:864-235-2335
Mailing Address - Fax:864-877-1260
Practice Address - Street 1:2700 E PHILLIPS RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650
Practice Address - Country:US
Practice Address - Phone:864-235-2335
Practice Address - Fax:864-877-1260
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC114442084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP01092462OtherRAILROAD MEDICARE
SC114441Medicaid
SCAA02884464Medicare PIN
SCP01092462OtherRAILROAD MEDICARE