Healthcare Provider Details

I. General information

NPI: 1265502082
Provider Name (Legal Business Name): SOUTH CAROLINA ORTHOPEDICS AND SPORTS MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E OAKLAND PARK BLVD # 356 SUITE 109
OAKLAND PARK FL
33334-2148
US

IV. Provider business mailing address

4611 HARD SCRABBLE RD SUITE 109
COLUMBIA SC
29229-8584
US

V. Phone/Fax

Practice location:
  • Phone: 843-319-9432
  • Fax: 800-640-5242
Mailing address:
  • Phone: 843-319-9432
  • Fax: 800-640-5242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY DEMOND MORGAN
Title or Position: OWNER PHYSICIAN
Credential: MD
Phone: 843-319-9432