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General NPI Number Information
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NPI Number | 1750348595
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Entity Type | Organization
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Legal Business Name | UPSTATE CAROLINA RADIOLOGY PA
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 101 E WOOD ST
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City | SPARTANBURG
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State | SC
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Zip | 29303-3040
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Country | US
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Telephone | 864-560-6522
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Fax | 888-972-8644
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Provider Business Mailing Address
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Address Line | PO BOX 745812
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City | ATLANTA
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State | GA
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Zip | 30374-5812
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. JAMES HASWELL
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Credential | MD
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Telephone | 864-560-6522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | SC
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