| Mr Carroll Brooks Bannister, MD | |
|
701 Medical Park Dr, Suite 101, Hartsville, SC 29550-4777 | |
| (843) 339-4295 | |
| (843) 339-4609 |
| Full Name | Mr Carroll Brooks Bannister |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 701 Medical Park Dr, Hartsville, 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 |
|---|---|---|---|
| 1689692253 | NPI | - | NPPES |
| 077188 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 7718 (South Carolina) | Primary |
| Entity Name | Hartsville Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598995300 PECOS PAC ID: 7012062714 Enrollment ID: O20090902000027 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Carroll Brooks Bannister, MD 701 Medical Park Dr, Ste 300, Hartsville, SC 29550-4777 Ph: (843) 878-1101 | Mr Carroll Brooks Bannister, MD 701 Medical Park Dr, Suite 101, Hartsville, SC 29550-4777 Ph: (843) 339-4295 |
Mr. Thomas Vanco Mincheff, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 704 Medical Park Drive, Hartsville Surgical Center Llp, Hartsville, SC 29550 Phone: 843-332-1099 Fax: 843-332-1091 | |
Dr. Patrick E Sizemore, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 704 Medical Park Dr, Hartsville, SC 29550 Phone: 843-332-1099 Fax: 843-339-1091 | |
Jason R Dameron, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 704 Medical Park Drive, Hartsville Surgical Center Llp, Hartsville, SC 29550 Phone: 843-332-1099 Fax: 843-332-1091 | |
Philip Chaipis, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 704 Medical Park Dr, Hartsville, SC 29550 Phone: 843-332-1099 |