Healthcare Provider Details

I. General information

NPI: 1245260470
Provider Name (Legal Business Name): ORVILLE H DYCE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 E CAROLINA AVE
HARTSVILLE SC
29550-4213
US

IV. Provider business mailing address

149 E CAROLINA AVE
HARTSVILLE SC
29550-4213
US

V. Phone/Fax

Practice location:
  • Phone: 843-383-5312
  • Fax: 843-383-6501
Mailing address:
  • Phone: 843-383-5312
  • Fax: 843-383-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number27632
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number27632
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number27632
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: