Basic Information
| Provider Information | |||||||||
| NPI: | 1972583367 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAYLOR | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3239 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295023239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437775065 | ||||||||
| FaxNumber: | 8436622474 | ||||||||
| Practice Location | |||||||||
| Address1: | 204 E CHEVES ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295062604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437775065 | ||||||||
| FaxNumber: | 8436622474 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2006 | ||||||||
| LastUpdateDate: | 02/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 01060811A | IN | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 32583 | SC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 229681 | 01 | SC | MEDCOST | OTHER | 057 | 01 | SC | BCBS | OTHER | 325838 | 05 | SC | MEDICAID |