1982680336 NPI number — JULIUS W BABB III MD

Table of content: JULIUS W BABB III MD (NPI 1982680336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982680336 NPI number — JULIUS W BABB III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BABB
Provider First Name:
JULIUS
Provider Middle Name:
W
Provider Name Prefix Text:
Provider Name Suffix Text:
III
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1982680336
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1245
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGEBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29116-1245
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-395-4497
Provider Business Mailing Address Fax Number:
803-536-0998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1175 COOK RD
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
ORANGEBURG
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29118-8201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-536-2555
Provider Business Practice Location Address Fax Number:
803-536-0998
Provider Enumeration Date:
12/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  6716 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 202K00000X , with the licence number: 6716 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 58467 . This is a "MEDCOST" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 020033989 . This is a "BANKERS LIFE & CASUALTY" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 576008010-012 . This is a "BCBS" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 8627144 . This is a "CIGNA" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 067162 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9645030 . This is a "GHI" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




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