Basic Information
Provider Information
NPI: 1063825230
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SPRINGS
FirstName: SAINT JULIEN
MiddleName: LACHICOTTE
NamePrefix: DR.
NameSuffix: II
Credential: M.D, MHA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 421718
Address2:  
City: GEORGETOWN
State: SC
PostalCode: 294424203
CountryCode: US
TelephoneNumber: 8436528226
FaxNumber:  
Practice Location
Address1: 4301 DICK POND RD
Address2:  
City: MYRTLE BEACH
State: SC
PostalCode: 295886807
CountryCode: US
TelephoneNumber: 8436528100
FaxNumber: 8436528122
Other Information
ProviderEnumerationDate: 06/05/2014
LastUpdateDate: 03/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X36926SCY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
3692601SCSC LICENSE BOARDOTHER


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