MEDICARE: ROCK HILL GYN & OB ASSOCIATES, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1245262294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCK HILL GYN & OB ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	PO BOX 2617
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-4617
Country	:	US
Telephone Number	:	803-548-2247
Fax Number	:	803-548-2286

Provider Business Practice Location Address
First Line	:	1666 HIGHWAY 160 W
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8024
Country	:	US
Telephone Number	:	803-548-2247
Fax Number	:	803-548-2286

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JANE Z GORMAN
Credential	:
Telephone Number	:	803-328-2401

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	04/25/2008

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