Organization · Type 2 NPI

Self Regional Healthcare

Family Medicine Physician · Laurens, SC

NPI number 1114726460 Active

Practice location

22580 Highway 76 E
Laurens, SC 29360-8460

Call (864) 833-5986 Map

Mailing address

104 Wells Ave
Greenwood, SC 29646-3837

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed
Sports Medicine (Family Medicine) Physician	207QS0010X	None listed
Internal Medicine Physician	207R00000X	None listed
Pulmonary Disease Physician	207RP1001X	None listed
Neurological Surgery Physician	207T00000X	None listed
Orthopaedic Surgery Physician	207X00000X	None listed
Physical Medicine & Rehabilitation Physician	208100000X	None listed
Psychiatry Physician	2084P0800X	None listed
Surgery Physician	208600000X	None listed
Urology Physician	208800000X	None listed
Foot & Ankle Surgery Podiatrist	213ES0103X	None listed
Urgent Care Clinic/Center	261QU0200X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

13 other providers at this address

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About NPI 1114726460

Self Regional Healthcare's National Provider Identifier is 1114726460, issued on Mar 10, 2025. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Laurens, SC. The record was last updated on Jun 4, 2026.