Bannister, Carroll Brooks

Bannister, Carroll Brooks is an individual health care provider with primary practice located at 701 Medical Park Dr Suite 101, Hartsville SC 29550-4777. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bannister, Carroll Brooks can be contacted via phone (843) 339-4295.

Contact Information

Primary practice address
701 Medical Park Dr Suite 101 Hartsville SC 29550-4777
Fax: (843) 339-4609
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 7718 South Carolina

Profile Details

NPI number 1689692253
LBN Legal business name Bannister, Carroll Brooks
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Mar 9th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689692253 NPPES
South Carolina MEDICAID 077188

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