Provider Demographics
NPI:1356988984
Name:FAMILY MEDICINE AND MOHR
Entity type:Organization
Organization Name:FAMILY MEDICINE AND MOHR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MOHR
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:843-407-9010
Mailing Address - Street 1:2811 W PALMETTO ST STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5931
Mailing Address - Country:US
Mailing Address - Phone:843-407-9010
Mailing Address - Fax:844-629-6711
Practice Address - Street 1:2811 W PALMETTO ST STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5931
Practice Address - Country:US
Practice Address - Phone:843-407-9010
Practice Address - Fax:844-629-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty