Provider Demographics
NPI:1215900675
Name:GARNER, JAMES S IV (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:GARNER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-292-7332
Mailing Address - Fax:843-292-7324
Practice Address - Street 1:3032 E HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-7396
Practice Address - Country:US
Practice Address - Phone:843-292-7332
Practice Address - Fax:843-292-7324
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8470207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC084704Medicaid
SCD79040Medicare UPIN
SCD790408552Medicare ID - Type Unspecified