| Carroll H Fowlkes Iii, DO | |
|
Beaufort Memorial Express Care & Occupational Health, 1 Burnt Church Rd, Ste A, Bluffton, SC 29910-6405 | |
| (843) 706-2185 | |
| (855) 299-5693 |
| Full Name | Carroll H Fowlkes Iii |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | Beaufort Memorial Express Care & Occupational Health, Bluffton, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578523890 | NPI | - | NPPES |
| 362084 | Medicaid | SC | |
| 6017444 | Medicaid | VA | |
| 0045396000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 0102049892 (Virginia) | Secondary |
| 207P00000X | Emergency Medicine | 36208 (South Carolina) | Primary |
| Entity Name | Beaufort County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871335018 PECOS PAC ID: 7810809365 Enrollment ID: O20050208000354 |
| Entity Name | Beaufort County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598713117 PECOS PAC ID: 7810809365 Enrollment ID: O20050518001061 |
| Entity Name | St Josephs Candler Urgent Care Centers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922580133 PECOS PAC ID: 5092058016 Enrollment ID: O20190520001421 |
| Mailing Address | Practice Location Address |
|---|---|
| Carroll H Fowlkes Iii, DO 955 Ribaut Rd, Bmac Credentialing, Beaufort, SC 29902-5441 Ph: (843) 522-7843 | Carroll H Fowlkes Iii, DO Beaufort Memorial Express Care & Occupational Health, 1 Burnt Church Rd, Ste A, Bluffton, SC 29910-6405 Ph: (843) 706-2185 |
Mr. Christopher M Opella, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Burnt Church Rd, Bluffton, SC 29910 Phone: 817-270-0788 Fax: 817-752-2176 | |
Dr. Atul Mohan Gupta, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 55a Sheridan Park Cir, Bluffton, SC 29910 Phone: 843-836-5111 Fax: 843-836-5112 |