Healthcare Provider Details

I. General information

NPI: 1982632931
Provider Name (Legal Business Name): GREENVILLE PODIATRY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ARBORLAND WAY
GREENVILLE SC
29615-2201
US

IV. Provider business mailing address

5 ARBORLAND WAY
GREENVILLE SC
29615-2201
US

V. Phone/Fax

Practice location:
  • Phone: 864-234-7370
  • Fax: 864-234-0779
Mailing address:
  • Phone: 864-234-7370
  • Fax: 864-234-0779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS MICHAEL JONES
Title or Position: PRESIDENT
Credential: DPM
Phone: 864-234-7370