Provider Demographics
NPI:1992753636
Name:BRITTIS, JOHN LOUIS (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LOUIS
Last Name:BRITTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:23 PLANTATION PARK DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910
Mailing Address - Country:US
Mailing Address - Phone:843-815-6555
Mailing Address - Fax:843-815-6553
Practice Address - Street 1:23 PLANTATION PARK DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910
Practice Address - Country:US
Practice Address - Phone:843-815-6555
Practice Address - Fax:843-815-6553
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC16859207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000810189797OtherPHCS
SC168598Medicaid
SC571114558OtherBCBS
660003315OtherRAILROAD MEDICARE
A4903OtherMEDCOST
GA00932643AMedicaid
GA00932643AMedicaid
SC168598Medicaid
000810189797OtherPHCS
SC168598Medicaid