Healthcare Provider Details

I. General information

NPI: 1982765160
Provider Name (Legal Business Name): BEAUFORT ORTHOPAEDIC SPORTS AND SPINE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1076 RIBAUT RD SUITE 101
BEAUFORT SC
29902-5476
US

IV. Provider business mailing address

1076 RIBAUT RD STE 101
BEAUFORT SC
29902-5477
US

V. Phone/Fax

Practice location:
  • Phone: 843-525-0045
  • Fax: 843-525-0826
Mailing address:
  • Phone: 843-525-0045
  • Fax: 843-525-0826

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: STEPHANIE GRIGGS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 843-525-0902