| Kevin Council Coppedge, DO | |
|
22725 Highway 76 E, Clinton, SC 29325-7527 | |
| (864) 833-9100 | |
| Not Available |
| Full Name | Kevin Council Coppedge |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 12 Years |
| Location | 22725 Highway 76 E, Clinton, South Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457762973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0102204536 (Virginia) | Secondary |
| 208M00000X | Hospitalist | 83403 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ghs Hospice Of The Foothills | Seneca, SC | Hospice |
| Ghs Laurens County Memorial Hospital | Clinton, SC | Hospital |
| Lewisgale Medical Center | Salem, VA | Hospital |
| Prisma Health Baptist Easley Hospital | Easley, SC | Hospital |
| Prisma Health Greenville Memorial Hospital | Greenville, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lake Spring Physician Services, Llc | 1254689482 | 85 |
| Prisma Health University Medical Group | 8325950983 | 2450 |
| Entity Name | Wildwood Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629560917 PECOS PAC ID: 1850649310 Enrollment ID: O20180731003816 |
| Entity Name | Lake Spring Physician Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568954287 PECOS PAC ID: 1254689482 Enrollment ID: O20180806000449 |
| Entity Name | Ingleside Physician Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932693488 PECOS PAC ID: 6103174255 Enrollment ID: O20180806001778 |
| Entity Name | Kingsford Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871088526 PECOS PAC ID: 0840541017 Enrollment ID: O20180927000385 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Council Coppedge, DO 300 E Mcbee Ave Fl 4, Greenville, SC 29601-2842 Ph: (864) 455-4411 | Kevin Council Coppedge, DO 22725 Highway 76 E, Clinton, SC 29325-7527 Ph: (864) 833-9100 |
Dr. Loghman Huseynov, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 22725 Highway 76 E, Clinton, SC 29325 Phone: 864-833-9100 |