Provider Demographics
NPI:1578348710
Name:BRITT, JAMES RANDALL JR
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RANDALL
Last Name:BRITT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 PHYSICIANS LN
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-3370
Mailing Address - Country:US
Mailing Address - Phone:803-777-7194
Mailing Address - Fax:
Practice Address - Street 1:540 PHYSICIANS LN
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-3370
Practice Address - Country:US
Practice Address - Phone:803-777-7194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28716363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care