Provider Demographics
NPI:1487730842
Name:HENDERSON, FRAMPTON WYMAN III (MD)
Entity type:Individual
Prefix:DR
First Name:FRAMPTON
Middle Name:WYMAN
Last Name:HENDERSON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-695-6071
Mailing Address - Fax:843-569-5879
Practice Address - Street 1:1101 OLD TROLLEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-5293
Practice Address - Country:US
Practice Address - Phone:843-875-0400
Practice Address - Fax:843-871-6700
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2021-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC28041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP01671839OtherRR MEDICARE
SC280412Medicaid
SC280412Medicaid
SCSC54605281Medicare PIN