Provider Demographics
NPI:1285693606
Name:PHILLIP & COKER OB-GYN LLC
Entity type:Organization
Organization Name:PHILLIP & COKER OB-GYN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:POSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-629-7074
Mailing Address - Street 1:PO BOX 60423
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0423
Mailing Address - Country:US
Mailing Address - Phone:843-629-7074
Mailing Address - Fax:
Practice Address - Street 1:1590 FREEDOM BLVD
Practice Address - Street 2:STE. B
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6071
Practice Address - Country:US
Practice Address - Phone:843-665-9581
Practice Address - Fax:843-669-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4182Medicaid
SCDD5603OtherRAILROAD MEDICARE
SC=========OtherBCBS OF SC
SCGP4182Medicaid
SCDD5603OtherRAILROAD MEDICARE
SC=========OtherAETNA
SC=========OtherMEDCOST
SC=========OtherSTANDARD TAX ID
SC=========OtherTRICARE
NC=========OtherBCBS OF NC