Provider Demographics
NPI:1801882527
Name:MCCOWN, JOHN S (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:MCCOWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:506 E CHEVES ST
Mailing Address - Street 2:P.O. BOX 1905
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2616
Mailing Address - Country:US
Mailing Address - Phone:843-413-3100
Mailing Address - Fax:843-413-3199
Practice Address - Street 1:506 E CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2616
Practice Address - Country:US
Practice Address - Phone:843-413-3100
Practice Address - Fax:843-413-3199
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2010-06-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC179322085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC154758900OtherFEDERAL BLACK LUNG
SC89565OtherMEDCOST
SC179327Medicaid
NC890502DOtherNC MEDICAID
NC0502DOtherBCBS OF NC
SC570525838OtherSTANDARD TAX ID
SC154758900OtherUS DEPT OF LABOR
SC300101176OtherRAILROAD MEDICARE
SCG91631Medicare UPIN
SC154758900OtherFEDERAL BLACK LUNG