Basic Information
| Provider Information | |||||||||
| NPI: | 1487619383 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HONAKER | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 412 KIMBALL DR | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295711916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8434239057 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 E PALMETTO ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295062851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436679414 | ||||||||
| FaxNumber: | 8436671362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 08/12/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 17870 | SC | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 9500942 | NC | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 17870 | SC | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8906437 | 05 | NC | MEDICAID | 183027 | 01 | SC | MEDCOST | OTHER | 178701 | 05 | SC | MEDICAID | 570835798 | 01 | SC | STANDARD TAX ID | OTHER | 155031900 | 01 | SC | US DEPT OF LABOR | OTHER |