Healthcare Provider Details

I. General information

NPI: 1104827302
Provider Name (Legal Business Name): JAMES ALLEN NAFZIGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 CARTER PARK DR SUITE A
SENECA SC
29678-1152
US

IV. Provider business mailing address

111 CARTER PARK DR SUITE A
SENECA SC
29678-1152
US

V. Phone/Fax

Practice location:
  • Phone: 864-882-1420
  • Fax: 864-886-0848
Mailing address:
  • Phone: 864-882-1420
  • Fax: 864-886-0848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number30361
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: