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General NPI Number Information
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NPI Number | 1649273749
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Entity Type | Organization
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Legal Business Name | GREENWOOD UROLOGICAL P.A.
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 01/19/2015
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Provider Practice Location Address
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Address Line | 109 LINER DR
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City | GREENWOOD
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State | SC
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Zip | 29646-2311
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Country | US
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Telephone | 800-922-4194
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Fax |
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Provider Business Mailing Address
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Address Line | 109 LINER DRIVE
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City | GREENWOOD
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State | SC
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Zip | 29646
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Country | US
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Telephone | 800-922-4194
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CLAUDIA E. KING
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Credential |
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Telephone | 800-922-4794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | SC
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