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Contact Information

PHILLIP L. LATHAM JR
325 BROAD STREET
SUITE 200
SUMTER, SC29150
 Phone: 803-775-4469
 Fax: 803-775-4981
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for PHILLIP L. LATHAM JR

NPI Number 1407947955
LBN Legal business name PHILLIP L. LATHAM JR
Authorized official MILLIE DORMAN - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/28/2006
Last updated 12/10/2010 - About 15 years ago
Identifiers
SC License # 14449
SC Medicaid 144490
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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