Basic Information
| Provider Information | |||||||||
| NPI: | 1013957844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABERNETHY | ||||||||
| FirstName: | DON | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4416 FOREST DR | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292063104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037824278 | ||||||||
| FaxNumber: | 8037823445 | ||||||||
| Practice Location | |||||||||
| Address1: | 70 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | COMMERCE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305291078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063351000 | ||||||||
| FaxNumber: | 7063357701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 07/25/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 16791 | SC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 16791 | SC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207P00000X | 39989 | GA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 167919 | 05 | SC | MEDICAID |