| Angel Oak Family Medicine Llc | |
|
1816 Bohicket Rd Ste F Johns Island SC 29455-3318 | |
| (843) 559-1938 | |
| Not Available |
| Full Name | Angel Oak Family Medicine Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1816 Bohicket Rd Ste F, Johns Island, South Carolina |
| Authorized Official Name and Position | Jacqueline Leonara Baer (PROVIDER) |
| Authorized Official Contact | 8435591938 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Oak Family Medicine Llc Po Box 336 Johns Island SC 29457-0336 Ph: (843) 559-1938 | Angel Oak Family Medicine Llc 1816 Bohicket Rd Ste F Johns Island SC 29455-3318 Ph: (843) 559-1938 |
| NPI Number | 1902083058 |
|---|---|
| Provider Enumeration Date | 01/30/2008 |
| Last Update Date | 12/06/2012 |
| Medicare PECOS PAC ID | 8426098708 |
|---|---|
| Medicare Enrollment ID | O20050505000737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902083058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | RHC153 (South Carolina) | Primary |
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