Healthcare Provider Details

I. General information

NPI: 1225006760
Provider Name (Legal Business Name): LOWCOUNTRY ORTHOPAEDIC ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 TRICOM ST
N CHARLESTON SC
29406-9171
US

IV. Provider business mailing address

2880 TRICOM ST
N CHARLESTON SC
29406-9171
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-5050
  • Fax: 843-797-3633
Mailing address:
  • Phone: 843-797-5050
  • Fax: 843-793-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: DON OWEN STOVALL JR.
Title or Position: PARTNER
Credential: M.D.
Phone: 843-797-5050