OrganizationActive
Mcleod Physician Associates II
NPI 1689869018 · Family Medicine Physician · Latta, SC
Provider details
- NPI number
- 1689869018
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Mcleod Health
- Organization subpart
- Yes
- Authorized official
- Paul Provenzano, Regional Practice Manager/Avp(843) 777-7030
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Rural Health Clinic/Center261QR1300X
Ambulatory Health Care Facilities
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
108a East Main Street
Latta, SC 29565-1617
Phone: (843) 752-5111
Fax: (843) 752-5100
Street-level locationGet directions
Mailing address
Po Box 3239
Florence, SC 29502-3239
Other names (DBA / former)
- Doing business as
- Mcleod Family Medicine - Latta
Registry dates
- Enumerated
- 2007-09-10
- Last updated
- 2009-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.