NPI 1003928680

Northlake Family Medical Practice

Organisation Family Medicine Physician Columbia, SC

Practice location

Address: 3000 NE Medical Park STE 101, Columbia, SC 29223-6251
Phone: (803) 419-5131
Fax: (803) 419-5130

Authorised official

Name: Reginald L Parker
Title: Owner
Phone: (803) 419-5131

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 14862 (SC)

Other Family Medicine providers in South Carolina →

Registry record

NPI: 1003928680
Entity type: Organization
NPI issued: 31 Aug 2006
Record last updated: 16 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.