Healthcare Provider Details

I. General information

NPI: 1346209210
Provider Name (Legal Business Name): ROBERT EDWARD FLANDRY JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 BOILING SPRINGS RD
SPARTANBURG SC
29303-2248
US

IV. Provider business mailing address

1075 BOILING SPRINGS RD
SPARTANBURG SC
29303-2248
US

V. Phone/Fax

Practice location:
  • Phone: 864-583-7265
  • Fax:
Mailing address:
  • Phone: 864-583-7265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number11358
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: