Healthcare Provider Details

I. General information

NPI: 1851389142
Provider Name (Legal Business Name): FAMILY PHYSICIANS OF BOILING SPRINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3941 HIGHWAY 9
BOILING SPRINGS SC
29316-8578
US

IV. Provider business mailing address

3941 HIGHWAY 9
BOILING SPRINGS SC
29316-8578
US

V. Phone/Fax

Practice location:
  • Phone: 864-560-3650
  • Fax: 864-560-3675
Mailing address:
  • Phone: 864-560-3650
  • Fax: 864-560-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberSC20281
License Number StateSC

VIII. Authorized Official

Name: DR. JENNIFER G. BAUGH
Title or Position: M.D
Credential: M.D.
Phone: 864-560-3650