Provider Demographics
NPI:1912062142
Name:BARTLETT, DONALD ELMER JR (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ELMER
Last Name:BARTLETT
Suffix:JR
Gender:M
Credentials:MD
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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:843-366-2900
Mailing Address - Fax:843-366-2450
Practice Address - Street 1:2021 N MYRTLE POINT BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-2224
Practice Address - Country:US
Practice Address - Phone:843-366-2900
Practice Address - Fax:843-366-2450
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2024-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101039372207QA0401X
SC91744207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine