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General NPI Number Information
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NPI Number | 1689866642
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Entity Type | Organization
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Legal Business Name | ANTHONY L MATHIS DPM LLC
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 127 MILLS AVE.
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City | GREER
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State | SC
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Zip | 29651
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Country | US
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Telephone | 864-879-4080
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Fax | 864-879-4938
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Provider Business Mailing Address
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Address Line | 127 MILLS AVENUE
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City | GREER
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State | SC
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Zip | 29651
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Country | US
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Telephone | 864-879-4080
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Fax | 864-879-4938
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. ANTHONY L MATHIS
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Credential | DPM LLC
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Telephone | 864-879-4080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 502
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License Number State | SC
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