Healthcare Provider Details

I. General information

NPI: 1184075640
Provider Name (Legal Business Name): WILLIAM KLIPHPATRICK LOVE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 N CHURCH ST STE 510
SPARTANBURG SC
29303-3077
US

IV. Provider business mailing address

853 N CHURCH ST STE 510
SPARTANBURG SC
29303-3077
US

V. Phone/Fax

Practice location:
  • Phone: 864-560-6193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberLL39794
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: