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General NPI Number Information
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NPI Number | 1154484558
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Entity Type | Organization
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Legal Business Name | CAROLINA BONE & JOINT PA
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 1228 COLONIAL COMMONS CT
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City | LANCASTER
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State | SC
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Zip | 29720-2200
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Country | US
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Telephone | 803-289-2663
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Fax | 803-286-8332
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Provider Business Mailing Address
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Address Line | PO BOX 5002
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City | MONROE
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State | NC
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Zip | 28111-5002
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Country | US
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Telephone | 803-289-2663
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Fax | 803-286-8332
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JOHN FRANKLYN BABICH
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Credential | MD
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Telephone | 704-289-4595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic 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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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