| Good Shepherd Family Practice, Pa | |
|
111 N Earle St Walhalla SC 29691-2419 | |
| (864) 614-2182 | |
| (864) 718-5354 |
| Full Name | Good Shepherd Family Practice, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 111 N Earle St, Walhalla, South Carolina |
| Authorized Official Name and Position | James W. N. Cochran (OWNER) |
| Authorized Official Contact | 8646142182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Shepherd Family Practice, Pa 235 Scenic Heights Rd West Union SC 29696-3134 Ph: (864) 614-2182 | Good Shepherd Family Practice, Pa 111 N Earle St Walhalla SC 29691-2419 Ph: (864) 614-2182 |
| NPI Number | 1861502890 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861502890 | NPI | - | NPPES |
| 156663 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 15666 (South Carolina) | Primary |
Prisma Health-upstate Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 103 Whitetail Dr, Walhalla, SC 29691 Phone: 864-638-3444 Fax: 864-638-3445 | |
Oconee Medical Associates, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 106 Whitetail Dr, Walhalla, SC 29691 Phone: 864-638-2388 | |
Prisma Health-upstate Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Whitetail Dr, Walhalla, SC 29691 Phone: 864-638-3444 Fax: 864-638-3445 |