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General NPI Number Information
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NPI Number | 1154437515
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Entity Type | Organization
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Legal Business Name | GREENWOOD SURGICAL ASSOC.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 160 ACADEMY AVE
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City | GREENWOOD
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State | SC
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Zip | 29646-3808
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Country | US
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Telephone | 864-223-8090
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Fax | 864-223-4026
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Provider Business Mailing Address
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Address Line | 160 ACADEMY AVE
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City | GREENWOOD
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State | SC
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Zip | 29646-3808
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Country | US
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Telephone | 864-223-8090
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Fax | 864-223-4026
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | HOPE A PRUITT
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Credential |
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Telephone | 864-223-8090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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