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General NPI Number Information
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NPI Number | 1235101965
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Entity Type | Organization
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Legal Business Name | PIEDMONT PATHOLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 404 E CALHOUN ST
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City | ANDERSON
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State | SC
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Zip | 29621-5803
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Country | US
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Telephone | 800-779-4858
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Fax | 864-231-8227
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Provider Business Mailing Address
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Address Line | 404 E CALHOUN ST
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City | ANDERSON
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State | SC
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Zip | 29621-5803
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Country | US
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Telephone | 800-779-4858
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Fax | 864-231-6448
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Authorized Official
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Title or Position | PRESIDENT
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Name | RUSSELL E. DODDS
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Credential | MD
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Telephone | 800-779-4858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 10667
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | 14206
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | 10667
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 7122
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License Number State | SC
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