Provider Demographics
NPI:1942008685
Name:MCLEOD PHYSICIAN ASSOCIATES II
Entity type:Organization
Organization Name:MCLEOD PHYSICIAN ASSOCIATES II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-777-7010
Mailing Address - Street 1:506 E CHEVES ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2616
Mailing Address - Country:US
Mailing Address - Phone:843-777-7010
Mailing Address - Fax:843-777-5572
Practice Address - Street 1:3617 CASEY ST STE B
Practice Address - Street 2:
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-2981
Practice Address - Country:US
Practice Address - Phone:843-716-8300
Practice Address - Fax:843-716-9792
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCLEOD HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty